Comparing the effect of unfractionated heparin and low molecular weight heparin in preventing of deep vein thrombosis prophylaxis after craniotomy in patients with brain tumor

کرانیوتومی با توجه به مستعد کردن بیماران به بی حرکتی، پس از عمل عاملی خطرساز برای ایجاد ترومبوز وریدی محسوب می شود. هدف از مطالعه حاضر مقایسه اثر دو روش درمان رایج برای پیشگیری از ترومبوز وریدی شامل هپارین معمولی ((unfractionated و هپارین با وزن مولکولی کم (کلگزان) در پیشگیری از این عارضه است. روش بررسی: در این کارآزمایی بالینی تصادفی و دوسوکور که از سال 1387 تا 1389 در اصفهان انجام شد، تعداد 154 بیمار که به علت تومور مغزی مورد عمل جراحی کرانیوتومی قرار گرفته در دو گروه تقسیم و مورد مطالعه قرار گرفتند. در گروه اول از 48 ساعت بعد از عمل کلگزان به میزان mg/d 40 به صورت زیرجلدی تجویز شد. بیماران در گروه دوم از 48 ساعت بعد از عمل، هپارین unfractionated به میزان IU/12h 5000 به صورت زیرجلدی دریافت کردند و نتایج در نرم افزار با کمک آزمون های T-test و Chi-Square مورد تجزیه و تحلیل قرار گرفتند. یافته ها:در این مطالعه تفاوت آماری معنی داری از نظر سن، جنس و بیماری های زمینه ای بین دو گروه مشاهده نشد (05/0P>). طی مطالعه 14 مورد (2/18) ترومبوز وریدهای عمقی تحت بالینی در گروه هپارین و 3 مورد (9/3) در گروه کلگزان مشاهده شد (011/0=P). هیچکدام از بیماران در پیگیری پس از کرانیوتومی دچار خونریزی داخل مغزی نشدند. نتیجه گیری: نتایج مطالعه حاضر نشان می دهد که کلگزان نسبت به هپارین unfractionated در پیشگیری از ترومبوز ورید عمقی پس از کرانیوتومی در بیماران مبتلا به تومور مغزی مؤثرتر و ایمن تر است

Estudio experimental de la acumulación de partículas atmosféricas de cristales en la transmisión de luz diurna

Daylight is one of the most significant light source which could illuminate interior spaces by passing through windows and light collectors. Dust and aerosol accumulation on windowpanes reduce the light amount passing through it. The main objective of this research is to determine the impact of airborne particulate matters deposition on past light quantity. In this experiment the most prevalent particulate matters such as dust, carbon, and a mixture of both examined with 3 mm common commercial glasses at single and double glaze windowpanes and several interesting observations have been obtained. The result of this experiment will help building owners to adjust a window-cleaning schedule to reduce their lighting electricity consumption and expenses.La luz del día es una de las fuentes de luz más importantes que podría iluminar los espacios interiores al pasar a través de ventanas y colectores de luz. La acumulación de polvo y aerosoles en los cristales de las ventanas reduce la cantidad de luz que pasa a través de ellos. El objetivo principal de esta investigación es determinar el impacto de la deposición de partículas en el aire sobre la cantidad de luz pasada. En este experimento, se obtuvieron las partículas más prevalentes, como el polvo, el carbono y una mezcla de ambos examinados con vidrios comerciales comunes de 3 mm en cristales de vidrios simples y dobles y se obtuvieron varias observaciones interesantes. El resultado de este experimento ayudará a los propietarios de edificios a ajustar un programa de limpieza de ventanas para reducir el consumo y los gastos de electricidad de iluminación

Estudio experimental de la acumulación de partículas atmosféricas de cristales en la transmisión de luz diurna

La luz del día es una de las fuentes de luz más importantes que podría iluminar los espacios interiores al pasar a través de ventanas y colectores de luz. La acumulación de polvo y aerosoles en los cristales de las ventanas reduce la cantidad de luz que pasa a través de ellos. El objetivo principal de esta investigación es determinar el impacto de la deposición de partículas en el aire sobre la cantidad de luz pasada. En este experimento, se obtuvieron las partículas más prevalentes, como el polvo, el carbono y una mezcla de ambos examinados con vidrios comerciales comunes de 3 mm en cristales de vidrios simples y dobles y se obtuvieron varias observaciones interesantes. El resultado de este experimento ayudará a los propietarios de edificios a ajustar un programa de limpieza de ventanas para reducir el consumo y los gastos de electricidad de iluminació

Response and Acquired Resistance to Everolimus in Anaplastic Thyroid Cancer

Everolimus, an inhibitor of the mammalian target of rapamycin (mTOR), is effective in treating tumors harboring alterations in the mTOR pathway. Mechanisms of resistance to everolimus remain undefined. Resistance developed in a patient with metastatic anaplastic thyroid carcinoma after an extraordinary 18-month response. Whole-exome sequencing of pretreatment and drug-resistant tumors revealed a nonsense mutation in TSC2, a negative regulator of mTOR, suggesting a mechanism for exquisite sensitivity to everolimus. The resistant tumor also harbored a mutation in MTOR that confers resistance to allosteric mTOR inhibition. The mutation remains sensitive to mTOR kinase inhibitors

Prevalence and predictors of low back pain among the Iranian population: Results from the Persian cohort study

Background and objectives: Low back pain (LBP) is a common health condition in populations. Limited large-scale population-based studies evaluated the prevalence and predictors of LBP in developing countries. This study aimed to evaluate the prevalence and factors associated with LBP among the Iranian population. Methods: We used baseline information from the Prospective Epidemiological Research Studies in Iran (PERSIAN), including individuals from 16 provinces of Iran. LBP was defined as the history of back pain interfering with daily activities for more than one week during an individual's lifetime. Various factors hypothesized to affect LBP, such as age, sex, marital status, educational status, ethnicity, living area, employment status, history of smoking, body mass index (BMI), physical activity, sleep duration, wealth score, history of joint pain, and history of morning stiffness in the joints were evaluated. Results: In total, 163770 Iranians with a mean age of 49.37 (SD = 9.15) were included in this study, 44.8% of whom were male. The prevalence of LBP was 25.2% among participants. After adjusting for confounders, the female gender [OR:1.244(1.02-1.50)], middle and older ages [OR:1.23(1.10-1.33) and OR:1.13(1.07-1.42), respectively], being overweight or obese [OR:1.13(1.07-1.19) and OR:1.21(1.16-1.27), respectively], former and current smokers (OR:1.25(1.16-1.36) and OR:1.28(1.17-1.39), respectively], low physical activity [OR:1.07 (1.01-1.14)], and short sleep duration [OR: 1.09(1.02-1.17)] were significantly associated with LBP. Conclusion: In this large-scale study, we found the lifetime prevalence of LBP to be lower among the Iranian population in comparison to the global prevalence of LBP; further studies are warranted to evaluate the causality of risk factors on LBP

Global, regional, and national burden of chronic kidney disease, 1990–2017 : a systematic analysis for the Global Burden of Disease Study 2017

Background Health system planning requires careful assessment of chronic kidney disease (CKD) epidemiology, but data for morbidity and mortality of this disease are scarce or non-existent in many countries. We estimated the global, regional, and national burden of CKD, as well as the burden of cardiovascular disease and gout attributable to impaired kidney function, for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. We use the term CKD to refer to the morbidity and mortality that can be directly attributed to all stages of CKD, and we use the term impaired kidney function to refer to the additional risk of CKD from cardiovascular disease and gout. Methods The main data sources we used were published literature, vital registration systems, end-stage kidney disease registries, and household surveys. Estimates of CKD burden were produced using a Cause of Death Ensemble model and a Bayesian meta-regression analytical tool, and included incidence, prevalence, years lived with disability, mortality, years of life lost, and disability-adjusted life-years (DALYs). A comparative risk assessment approach was used to estimate the proportion of cardiovascular diseases and gout burden attributable to impaired kidney function. Findings Globally, in 2017, 1·2 million (95% uncertainty interval [UI] 1·2 to 1·3) people died from CKD. The global all-age mortality rate from CKD increased 41·5% (95% UI 35·2 to 46·5) between 1990 and 2017, although there was no significant change in the age-standardised mortality rate (2·8%, −1·5 to 6·3). In 2017, 697·5 million (95% UI 649·2 to 752·0) cases of all-stage CKD were recorded, for a global prevalence of 9·1% (8·5 to 9·8). The global all-age prevalence of CKD increased 29·3% (95% UI 26·4 to 32·6) since 1990, whereas the age-standardised prevalence remained stable (1·2%, −1·1 to 3·5). CKD resulted in 35·8 million (95% UI 33·7 to 38·0) DALYs in 2017, with diabetic nephropathy accounting for almost a third of DALYs. Most of the burden of CKD was concentrated in the three lowest quintiles of Socio-demographic Index (SDI). In several regions, particularly Oceania, sub-Saharan Africa, and Latin America, the burden of CKD was much higher than expected for the level of development, whereas the disease burden in western, eastern, and central sub-Saharan Africa, east Asia, south Asia, central and eastern Europe, Australasia, and western Europe was lower than expected. 1·4 million (95% UI 1·2 to 1·6) cardiovascular disease-related deaths and 25·3 million (22·2 to 28·9) cardiovascular disease DALYs were attributable to impaired kidney function. Interpretation Kidney disease has a major effect on global health, both as a direct cause of global morbidity and mortality and as an important risk factor for cardiovascular disease. CKD is largely preventable and treatable and deserves greater attention in global health policy decision making, particularly in locations with low and middle SDI

The impact of tumor profiling approaches and genomic data strategies for cancer precision medicine

Background: The diversity of clinical tumor profiling approaches (small panels to whole exomes with matched or unmatched germline analysis) may engender uncertainty about their benefits and liabilities, particularly in light of reported germline false positives in tumor-only profiling and use of global mutational and/or neoantigen data. The goal of this study was to determine the impact of genomic analysis strategies on error rates and data interpretation across contexts and ancestries. Methods: We modeled common tumor profiling modalities—large (n = 300 genes), medium (n = 48 genes), and small (n = 15 genes) panels—using clinical whole exomes (WES) from 157 patients with lung or colon adenocarcinoma. We created a tumor-only analysis algorithm to assess germline false positive rates, the impact of patient ancestry on tumor-only results, and neoantigen detection. Results: After optimizing a germline filtering strategy, the germline false positive rate with tumor-only large panel sequencing was 14 % (144/1012 variants). For patients whose tumor-only results underwent molecular pathologist review (n = 91), 50/54 (93 %) false positives were correctly interpreted as uncertain variants. Increased germline false positives were observed in tumor-only sequencing of non-European compared with European ancestry patients (p < 0.001; Fisher’s exact) when basic germline filtering approaches were used; however, the ExAC database (60,706 germline exomes) mitigated this disparity (p = 0.53). Matched and unmatched large panel mutational load correlated with WES mutational load (r2 = 0.99 and 0.93, respectively; p < 0.001). Neoantigen load also correlated (r2 = 0.80; p < 0.001), though WES identified a broader spectrum of neoantigens. Small panels did not predict mutational or neoantigen load. Conclusions: Large tumor-only targeted panels are sufficient for most somatic variant identification and mutational load prediction if paired with expanded germline analysis strategies and molecular pathologist review. Paired germline sequencing reduced overall false positive mutation calls and WES provided the most neoantigens. Without patient-matched germline data, large germline databases are needed to minimize false positive mutation calling and mitigate ethnic disparities. Electronic supplementary material The online version of this article (doi:10.1186/s13073-016-0333-9) contains supplementary material, which is available to authorized users

Alterations in juvenile diploid and triploid African catfish skin gelatin yield and amino acid composition: effects of chlorpyrifos and butachlor exposures

Skin is a major by-product of the fisheries and aquaculture industries and is a valuable source of gelatin. This study examined the effect of triploidization on gelatin yield and proximate composition of the skin of African catfish (Clarias gariepinus). We further investigated the effects of two commonly used pesticides , chlorpyrifos (CPF) and butachlor (BUC), on the skin gelatin yield and amino acid composition in juvenile full-sibling diploid and triploid African catfish. In two separate experiments, diploid and triploid C. gariepinus were exposed for 21 days to graded CPF [mean measured: 10, 16, or 31 mg/L] or BUC concentrations [Mean measured: 22, 44, or 60 mg/L]. No differences in skin gelatin yield, amino acid or proximate compositions were observed between diploid and triploid control groups. None of the pesticide treatments affected the measured parameters in diploid fish. In triploids, however, gelatin yield was affected by CPF treatments while amino acid composition remained unchanged. Butachlor treatments did not alter any of the measured variables in triploid fish. To our knowledge, this study is the first to investigate changes in the skin gelatin yield and amino acid composition in any animal as a response to polyploidization and/or contaminant exposure

Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy

Background A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets. Methods Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall’s tau for dichotomous variables, or Jonckheere–Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis. Results A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p < 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p < 0.001). Conclusion We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty