Association Between Overweight and Obesity and Overactive Bladder in Children: A Cross-sectional Study

Background: Overactive bladder (OAB) is a common cause of voiding dysfunction in children and is classified as lower urinary tract dysfunction (LUTD). In recent studies, obesity and overweight are assumed as risk factors for voiding dysfunction and urinary incontinence in children. Objectives: This study was conducted to evaluate the correlation between overweight and obesity with OAB in children. Methods: This cross-sectional study measured BMI in 56 children aged between 3 and 16 years with OAB (case group) and 56 healthy matched children (control group). Overweight and obesity were compared between the two groups. The study also accessed lower urinary tract symptoms and their association with BMI in the OAB children. The data were analyzed using the SPSS software version 18.0 for windows (SPSS Inc., Chicago, IL). Results: The mean age of the OAB patients was 7.71_2.65 years, and 38 (67.8%) of them were female. Frequency and holding maneuvers were the most prevalent complaints. A history of urinary tract infection was detected in 46 (82.1%) of the OAB patients. There were no significant differences in overweight and obesity between the two groups (P = 0.23). Conclusions: No correlation was observed between overweight and obesity with OAB. The reason may be different socioeconomic conditions or malnutrition in these children. Thus, it is recommended to perform a study with a larger sample size in our community to assess malnutrition in the general children population. Keywords: Children, Overactive Bladder, Body Mass Index, Urinary Incontinence, Urinary Tract Infectio

Preventable risk factors of hospital readmission in stroke patients: an integrative review

Background: Despite advances in medical treatments, readmission of stroke patients remains high and has been reported between 31% and 56.1% during the first year after discharge. The difference between the risk factors of readmission and the risk factors of stroke is not clear. The purpose of this study is: 1) to determine the preventable risk factors associated with stroke readmission and 2) to provide a conceptual model for preventable factors that effective in the readmission of stroke patients. Methods: This integrated review was performed according to Whittemore and Knafl (2005) method in five stages including problem identification, literature search, data evaluation, data analysis, and presentation. In order to find relevant articles, PubMed, Web of Science, CINAHL, Scopus databases and Google Scholar search engine were searched. The search was conducted using the keywords "stroke," "readmission," "recurrence," "re-hospitalization," "review," and "systematic review," for the period between January 2023 and September 2023, following the PRISMA guidelines. In addition to providing a qualitative synthesis of readmission factors categorized into categories, a conceptual model of these factors was also presented. Results: Out of a total of 3785 article titles, 38 articles were included in the study for the final analysis after screening and removing duplicates. The most important risk factors for readmission in four categories: (1) knowledge deficit about the comorbidities (such as hypertension, atrial fibrillation, diabetes), (2) unhealthy diet and medicine, (3) high-risk behaviors (smoking, alcohol consumption, and tobacco use disorder), and (4) psychological distress (depression and worry about the future). In addition, the conceptual model showed that the most important preventable factor in readmission of stroke patients is of knowledge deficit about comorbidities (especially hypertension).  Conclusion: The most important preventable risk factors that are effective in the readmission of stroke patients are knowledge deficit regarding clinical risk factors, especially high blood pressure, high-risk behaviors and unhealthy diet and medicine. Therefore, more detailed care and follow-up programs should be designed for stroke patients after discharge

INFLUENCE OF SHORT TERM INTRAVENOUS ANTICOAGULATION THERAPY IN PATIENTS WITH ISCHEMIC CEREBROVASCULAR EVENTS

Abstract &nbsp;&nbsp; BACKGROUND: Progressive stroke (PS) and Crescendo Transient Ischemic Attacks (CTIA) is a generally accepted although unproven, indication for urgent intravenous anticoagulation therapy. &nbsp;&nbsp; METHODS: Consecutive patients with PS and CTIA admitted in Ghaem hospital, Mashhad during 2007 - 2008 enrolled in a prospective clinical study. PS and CTIA patients underwent intravenous heparin therapy with 1000 units per hour without a bolus dose at least for 3 days. PS and CTIA patients who had a contraindication for intravenous hepain therapy, received 80 mg Aspirin per day. Early clinical course including improvement, stabilization, deterioration and development of residual stroke was evaluated in two therapeutic groups of PS and CTIA patients. &nbsp;&nbsp; RESULTS: 170 PS patients (103 males, 67 females) with mean age of 60.4 &plusmn; 12.3 years and 88 CTIA patients (50 males, 38 females) with mean age of 60.1 &plusmn; 6.8 years were assessed. 141 PS and 64 CTIA patients received short period intravenous heparinization. Distribution of subtypes of early clinical course between two therapeutic groups of PS and CTIA patients, was significantly different; X2 = 10.487, df = 2, p = 0.005 and X2 = 6.72, df = 2, p = 0.035 respectively. Distribution of residual stroke in two therapeutic groups of PS and CTIA patients,was not significantly different; X2 = 1.443, df = 1, p = 0.23, OR = 0.557 (0.212-1.462) and X2 = 1.01, df = 1, p = 0.315, OR = 0.617 (0.24-1.587) respectively. &nbsp;&nbsp; CONCLUSION: PS and CTIA patients who underwent short period intravenous heparin therapy have significantly more probability of improvement and less probability of deterioration in their early clinical course than PS and CTIA patients who received Aspirin therapy. &nbsp; &nbsp;&nbsp; Keywords: Progressive Stroke (PS) Crescendo TransientIschemic Attacks (CTIA), Intravenous anticoagulation therapy, Heparin therapy.</p

‎ The Association between Life Satisfaction and the Extent of ‎Depression, ‎Anxiety and Stress among Iranian Nurses: A ‎Multicenter Survey

Objective: The determinants of satisfaction of life (SWL) are poorly described among Iranian employed ‎nurses. This study aimed to assess the effect of various factors including age, gender, marital ‎status, depression, anxiety and stress on SWL among Iranian nurses.‎ Method: Employed nurses in three teaching hospitals were invited to participate in this study. Ninety-four ‎nurses (65 women and 29 men) participated in this study. Depression, anxiety, stress scale ‎‎ (DASS-21) was used to measure the related variables. Satisfaction with Life Scale (SWLS) was ‎used to assess SWL. Multivariate analysis was utilized to examine the relationship between ‎multiple variables. Results: A noticeable proportion of Iranian employed nurses were either dissatisfied or extremely ‎dissatisfied with life (45%). Severe depression was related to lower scores of SWLS (P: 0.001, r ‎‎= -0.32). The similar outcomes were detected between anxiety and stress scales, and SWLS (P: ‎‎0.023, r = -0.23 and P: 0.008, r = -0.27 for anxiety and stress, respectively). Although females ‎were more vulnerable to depression (P: 0.010) and stress (P: 0.013), the overall effect of gender ‎on SWL was insignificant (0.41). Satisfactions with financial power and work environment were ‎associated with higher scores of SWLS (P: 0.030 and 0.042, respectively). Marital status was not ‎related to severity of depression, anxiety, stress and SWLS (P: 0.39, 0.38, 0.80, and 0.61, ‎respectively). ‎ Conclusion: This study revealed that poor satisfaction with financial status and work environment, ‎depression, anxiety and stress are the major determinants of satisfaction with life among Iranian ‎employed nurses.

Effect of bone marrow derived mesenchymal stem cells on lung pathology and inflammation in ovalbumin-induced asthma in mouse

Objective(s):Bone marrow-derived mesenchymal stem cells (BMSCs) have attracted significant interest to treat asthma and its complication. In this study, the effects of BMSCs on lung pathology and inflammation in an ovalbumin-induced asthma model in mouse were examined. Materials and Methods:BALB/c mice were divided into three groups: control group (animals were not sensitized), asthma group (animals were sensitized by ovalbumin), asthma+BMSC group (animals were sensitized by ovalbumin and treated with BMSCs). BMSCs were isolated and characterized and then labeled with Bromodeoxyuridine (BrdU). After that the cells transferred into asthmatic mice. Histopathological changes of the airways, BMSCs migration and total and differential white blood cell (WBC) count in bronchoalveolar lavage (BAL) fluid were evaluated. Results:A large number of BrdU-BMSCs were found in the lungs of mice treated with BMSCs. The histopathological changes, BAL total WBC counts and the percentage of neutrophils and eosinophils were increased in asthma group compared to the control group. Treatment with BMSCs significantly decreased airway pathological indices, inflammatory cell infiltration, and also goblet cell hyperplasia. Conclusion:The results of this study revealed that BMSCs therapy significantly suppressed the lung pathology and inflammation in the ovalbumin induced asthma model in mouse

Feeding Mode of Australian Infants in the First 12 Months of Life: An Assessment against National Breastfeeding Indicators

BACKGROUND: In 2011, Australia published a set of 6 population-level indicators assessing breastfeeding, formula use, and the introduction of soft/semisolid/solid foods. OBJECTIVES: This study aimed to report the feeding practices of Australian infants against these indicators and determine the predictors of early breastfeeding cessation and introduction of solids. METHODS: Mother-infant dyads (N = 1470) were recruited postnatally in 2 Australian capital cities and regional areas of 1 state between February 2008 and March 2009. Demographic and feeding intention data were collected by self-completed questionnaire at infant birth, with feeding practices (current feeding mode, age of breastfeeding cessation, age of formula and/or solids introduction) reported when the infant was between 4 and 7 months of age, and around 13 months of age. Multiple logistic regression was used to determine the predictors of breastfeeding cessation and solids introduction. RESULTS: Although initiation of breastfeeding was almost universal (93.3%), less than half of the infants were breastfed to 6 months (41.7%) and 33.3% were receiving solids by 4 months. Women who were socially disadvantaged, younger, less educated, unpartnered, primiparous, and/or overweight were most likely to have ceased breastfeeding before 6 months of age, and younger and/or less educated women were most likely to have introduced solid food by 4 months of age. Not producing adequate milk was the most common reason provided for cessation of breastfeeding. CONCLUSION: The feeding behaviors of Australian infants in the first 12 months fall well short of recommendations. Women need anticipatory guidance as to the indicators of breastfeeding success and the tendency of women to doubt the adequacy of their breast milk supply warrants further investigation

Safety and outcomes of intravenous thrombolytic therapy in ischemic stroke patients with COVID-19: CASCADE initiative

BACKGROUND: There is little information regarding the safety of intravenous tissue plasminogen activator (IV-tPA) in patients with stroke and COVID-19. METHODS: This multicenter study included consecutive stroke patients with and without COVID-19 treated with IV-tPA between February 18, 2019, to December 31, 2020, at 9 centers participating in the CASCADE initiative. Clinical outcomes included modified Rankin Scale (mRS) at hospital discharge, in-hospital mortality, the rate of hemorrhagic transformation. Using Bayesian multiple regression and after adjusting for variables with significant value in univariable analysis, we reported the posterior adjusted odds ratio (OR, with 95% Credible Intervals [CrI]) of the main outcomes. RESULTS: A total of 545 stroke patients, including 101 patients with COVID-19 were evaluated. Patients with COVID-19 had a more severe stroke at admission. In the study cohort, 85 (15.9%) patients had a hemorrhagic transformation, and 72 (13.1%) died in the hospital. After adjustment for confounding variables, discharge mRS score ≥2 (OR: 0.73, 95% CrI: 0.16, 3.05), in-hospital mortality (OR: 2.06, 95% CrI: 0.76, 5.53), and hemorrhagic transformation (OR: 1.514, 95% CrI: 0.66, 3.31) were similar in COVID-19 and non COVID-19 patients. High-sensitivity C reactive protein level was a predictor of hemorrhagic transformation in all cases (OR:1.01, 95%CI: 1.0026, 1.018), including those with COVID-19 (OR:1.024, 95%CI:1.002, 1.054). CONCLUSION: IV-tPA treatment in patients with acute ischemic stroke and COVID-19 was not associated with an increased risk of disability, mortality, and hemorrhagic transformation compared to those without COVID-19. IV-tPA should continue to be considered as the standard of care in patients with hyper acute stroke and COVID-19