A comparative study on laws, policies and procedures of patient access to electronic health record in selected countries

زمینه و هدف: از منافع دسترسی به پرونده برای بیماران این است که به آنها اجازه داده شود تا درک بهتر از شرایط و درمانشان بدست آورند. هدف این پژوهش مقایسه خط مشی ها و قوانین حق دسترسی بیمار به پرونده الکترونیک سلامت در کشورهای استرالیا، کانادا، نیوزلند و مقایسه آن با ایران بود. روش بررسی: مطالعه از نوع توصیفی- تطبیقی است که قوانین، خط مشی و رویه های حق دسترسی بیمار به پرونده الکترونیک سلامت خود را در کشورهای استرالیا، کانادا، نیوزلند و مقایسه آنها با ایران بررسی کرده است. ابزار جمع آوری داده ها به شکل فیش برداری بوده است که از طریق مطالعات کتابخانه ای مقالات، کتب، مجلات و پایگاه های اطلاعاتی همچون Pubmed صورت گرفته و مقایسه شده است. یافته ها : یافته های پژوهش نشان می دهد که هر چهار کشور به طور معمول دارای تعدادی قوانین، خط مشی و رویه در رابطه با حق دسترسی می باشند. اما در هیچ کدام به طور واضح و مشخص میزان حق دسترسی تعیین نشده است. نتیجه گیری : در کشورهای مورد مطالعه در پژوهش حاضر قوانین، خط مشی ها و رویه های کلی وجود دارد که در مجموع به حق بیمار در زمینه دسترسی، محرمانگی، افشا یا واگذاری اطلاعات وی اشاره می کند؛ لذا با توجه به الزام پیاده سازی طرح سپاس، لزوم توجه به ایجاد قانون و یا حداقل خط مشی و رویه های اختصاصی و بیان کننده جزئیات این مورد کاملا مشهود می گردد

Minocycline through attenuation of oxidative stress and inflammatory response reduces the neuropathic pain in a rat model of chronic constriction injury

Objectives: Several lines of evidence showed that minocycline possesses antioxidant and anti-inflammatory properties. This study aimed to demonstrate the effects of minocycline in rats subjected to chronic constriction injury (CCI). Materials and Methods: In this study four groups (n = 6-8) of rats were used as follows: Sham, CCI, CCI + minocycline (MIN) 10 mg/Kg (IP) and CCI + MIN 30 mg/Kg (IP). On days 3, 7, 14, and 21 post-surgery hot-plate, acetone, and von Frey tests were carried out. Finally, Motor Nerve Conduction Velocity Evaluation (MNCV) assessment was performed and spinal cords were harvested in order to measure tissue concentrations of TNF_α, IL-1β, Glutathione peroxidase (GPx), Superoxide dismutase (SOD) and Malondialdehyde (MDA). Extent of perineural inflammation and damage around the sciatic nerve was histopathologically evaluated. Results: Our results demonstrated that CCI significantly caused hyperalgesia and allodynia twenty-one days after CCI. MIN attenuated heat hyperalgesia, cold and mechanical allodynia and MNCV in animals. MIN also decreased the levels of TNF_α and IL-1β. Antioxidative enzymes (SOD, MDA, and GPx) were restored following MIN treatment. Our findings showed that MIN decreased perineural inflammation around the sciatic nerve. According to the results, the neuropathic pain reduced in the CCI hyperalgesia model using 30 mg/kg of minocycline. Conclusion: It is suggested that antinociceptive effects of minocycline might be mediated through the inhibition of inflammatory response and attenuation of oxidative stress

Sonographic Optic Nerve Sheath Diameter as a Screening Tool for Detection of Elevated Intracranial Pressure

Introduction: Timely diagnosis and treatment of post traumatic, elevated intracranial pressure (EICP), could reduce morbidity and mortality, as well as improve patients’ outcome. This study is trying to evaluate the diagnostic accuracy of sonographic optic nerve sheath diameter (ONSD) in detection of EICP. Methods: Sonographic ONSD of patients with head trauma or cerebrovascular accident suspicious for EICP were evaluated by a trained chief resident of emergency medicine, who was blind to the clinical and brain computed tomography scan (BCT) findings of patients. Immediately after ultrasonography, BCT was performed and reported by an expert radiologist without awareness from other results of the patients. Finally, ultrasonographic and BCT findings regarding EICP were compared. To evaluate the ability of sonographic ONSD in predicting the BCT findings and obtain best cut-off level, receiver operating characteristic (ROC) curve were used. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), and negative likelihood ratio (NLR) of sonographic ONSD in determining of EICP was calculated. P < 0.05 was considered to be statistically significant. Results: There were 222 patients (65.3% male), with mean age of 42.2±19.5 years (range: 16-90 years). BCT showed signs of EICP, in 28 cases (12.6%). The means of the ONSD in the patients with EICP and normal ICP were 5.5 ± 0.56 and 3.93 ± 0.53 mm, respectively (P<0.0001). ROC curve demonstrated that the best cut off was 4.85 mm. Sensitivity, specificity, PPV, NPV, PLR, and NLR of ONSD for prediction of EICP were 96.4%, 95.3%, 72.2%, 98.9%, 20.6, and 0.04, respectively. Conclusion: Sonographic diameter of optic nerve sheath could be considered as an available, accurate, and noninvasive screening tool in determining the elevated intracranial pressure in cases with head trauma or cerebrovascular accident.

Colony site characteristics of sympatric breeding tern species on the Mond Islands, the Persian Gulf

We have investigated characteristics of colony site of three sympatric breeding tern species on small islands of a subtropical region, the Persian Gulf. The three most populous ground-nesting waterbird species – Bridled Tern Onychoprion anaethetus, Lesser Thalasseus bengalensis and Greater Thalasseus bergii Crested Terns – were studied during the 2009–2011 breeding seasons. The average area size of mixed colonies was 454 m2. The density of nests of the Bridled Tern was 846 nests/ha. The proportion of the number of nests in a mixed colony for Lesser Crested Tern (5546 nests) was approximately 10-fold compared to the Greater Crested Tern (542 nests). The density of Bridled Tern nests/ha was significantly higher in areas with 50–75% vegetation cover (>1200 nests/ha) than in areas of <5% vegetation cover (72–105 nests/ha) (p < 0.05). Mixed colonies of the Lesser and Greater Crested Terns were located on unvegetated land, at an average distance of 4.1 m to vegetation, and on sandy soil (79.4% on average) and above high spring tide water lines (0.59 m on average). There were more potential nesting areas than occupied areas for the mixed colonies of the Lesser and Greater Crested Terns, indicated that they did not face nest site limitation

Dynamics of bacteriophages as a promising antibiofilm agents

Pseudomonas aeruginosa is an ubiquitous organism which has emerged as a major threat in the hospital environment. Overuse of antibiotics has also significantly increased the emergence of antimicrobial multiresistant bacteria. P. aeruginosa has an innate ability to adhere to surfaces and form virulent biofilms. Bacteriophage might represent one attractive solution to this problem. In this study, P.aeruginosa phage were utilized to Biofilm inhibition and remove.Sample collected from University sewage. Isolation was done according to Martha.R.J.Clokie protocol. Serial dilution prepared, then equally incubated with bacteria to investigate Biofilm inhibition potential. Biofilm formed base on Microplate Biofilm Assay. The effect of isolated phage investigated on biofilm remove of Pseudomonas putida, E.coli and Acinetobacter baumanii. P.aeruginosa biofilm had OD: 1.688 in 492n.m. Pure phage, 10-2 and 10-3 diluted phage decreased OD to 1.587, 1.341 and 1.461, respectively. Isolated phage dramatically decline OD of Biofilm of all strains.Phages have various affinity to attach to hosts, thereby it is supposed to phages compete for their receptors. Therefore it is supposed phages have most efficiency in optimum concentration to remove biofilm or growth inhibition

Dynamics of PEGylated-dextran-spermine nanoparticles for gene delivery to leukemic cells.

Leukemic cells are hard-to-transfect cell lines. Many transfection reagents which can provide high gene transfer efficiency in common adherent cell lines are not effective to transfect established blood cell lines or primary leukemic cells. This study aims to examine a new class of cationic polymer non-viral vector, PEGylated-dextran-spermine (PEG-D-SPM), to determine its ability to transfect the leukemic cells. Here, the optimal conditions of the complex preparation (PEG-D-SPM/plasmid DNA (pDNA)) were examined. Different weight-mixing (w/w) ratios of PEG-D-SPM/pDNA complex were prepared to obtain an ideal mixing ratio to protect encapsulated pDNA from DNase degradation and to determine the optimal transfection efficiency of the complex. Strong complexation between polymer and pDNA in agarose gel electrophoresis and protection of pDNA from DNase were detected at ratios from 25 to 15. Highest gene expression was detected at w/w ratio of 18 in HL60 and K562 cells. However, gene expression from both leukemic cell lines was lower than the control MCF-7 cells. The cytotoxicity of PEG-D-SPM/pDNA complex at the most optimal mixing ratios was tested in HL60 and K562 cells using MTS assay and the results showed that the PEG-D-SPM/pDNA complex had no cytotoxic effect on these cell lines. Spherical shape and nano-nature of PEG-D-SPM/pDNA complex at ratio 18 was observed using transmission electron microscopy. As PEG-D-SPM showed modest transfection efficiency in the leukemic cell lines, we conclude that further work is needed to improve the delivery efficiency of the PEG-D-SPM

The antinociceptive effects of rosuvastatin in chronic constriction injury model of male rats

Introduction: According to studies, statins possess analgesics and anti-inflammatory properties. In the present study, we examined the antinociceptive, anti-inflammatory and antioxidative effects of rosuvastatin in an experimental model of Chronic Constriction Injury (CCI). Methods: Our study was conducted on four groups; sham, CCI (the control group), CCI+rosuvastatin (i.p. 5 mg/kg), and CCI+rosuvastatin (i.p. 10 mg/kg). We performed heat hyperalgesia, cold and mechanical allodynia tests on the 3rd, 7th, 14th, and 21st after inducing CCI. Blood samples were collected to measure the serum levels of Tumor Necrosis Factor (TNF)-α, and Interleukin (IL)-6. Rats' spinal cords were also examined to measure tissue concentration of Malondialdehyde (MDA), Superoxide Dismutase (SOD), and Glutathione Peroxidase (GPx) enzymes. Results: Our findings showed that CCI resulted in significant increase in heat hyperalgesia, cold and mechanical allodynia on the 7th, 14th and 21st day. Rosuvastatin use attenuated the CCI-induced hyperalgesia and allodynia. Rosuvastatin use also resulted in reduction of TNF-α, IL-6, and MDA levels. However, rosuvastatin therapy increased the concentration of SOD and GPx in the CCI+Ros (5 mg/kg) and the CCI+Ros (10 mg/kg) groups compared to the CCI group. Conclusion: Rosuvastatin attenuated the CCI-induced neuropathic pain and inflammation. Thus, antinociceptive effects of rosuvastatin might be channeled through inhibition of inflammatory biomarkers and antioxidant properties

A preliminary checklist of saproxylic beetles (Coleoptera) in the Hyrcanian forests of Iran, with distributional data

Saproxylic beetles play a vital role in conservation as indicators of the status of unmanaged forests. In light of the concern regarding the adverse impact of anthropogenic pressure on biodiversity, an essential step in forest conserva-tion strategy is the identification of saproxylic beetles. The Hyrcanian forests are a unique remnant of natural broadleaf temperate forests, with an evolutionary history that can be traced to the Tertiary and a high diversity tree species. Here we present the first checklist of saproxylic beetles in the Hyrcanian forests, including 398 species of saproxylic beetles, belonging to 207 genera and 46 families, identified by us. Based on our results and literature data, at least 670 saproxylic beetles occur in the Hyrcanian forests. The bias in our results towards some families supports the view that the detection of additional species can be expected, particularly from the forests with a greater diversity of tree species

The Combination of Zerumbone and 5-FU: A Significant Therapeutic Strategy in Sensitizing Colorectal Cancer Cells to Treatment

Objectives. Chemotherapy is considered to be essential in the treatment of patients with colorectal cancer (CRC), but drug resistance reduces its efficacy. Many patients with advanced CRC eventually show resistance to 5-fluorouracil (5-FU) therapy. Synergistic and potentiating effects of combination therapy, using herbal and chemical drugs, can improve patients’ response. Zerumbone (ZER), which is derived from ginger, has been studied for its growth inhibitory function in various types of cancer. Methods. The cytotoxic effects of ZER and 5-FU alone and their combination, on the SW48 and HCT-116 cells, were examined, using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT). The mRNA and protein levels of β-catenin, survivin, and vimentin were measured in treated CRC cells, using qRT-PCR and western blot. Colony formation assay, scratch test, and flow cytometry were performed to detect the changes of proliferation, migration, and apoptosis. Key Findings. In HCT-116- and SW48-treated cells, the proliferation, the gene and protein expression levels of the markers, the migration, the colony formation, and the survival rates were all significantly reduced compared to the control groups, and the sharpest decline was observed in the 5-FU+ZER treatment groups. Conclusions. Combination therapy has shown promising results in CRC cells, especially in drug-resistant cells