Iatrogenic Cushing's syndrome caused by topical corticosteroid application and its life threatening complications

Introduction: The use of topical corticosteroids in children and adults, especially in covered areas and for a prolonged duration, may result in Cushing's syndrome and suppression of the hypothalamic-pituitary-adrenal axis. Case Presentation: The present report describes the cases of three children and a 25-year-old man who presented with clinical features of Cushing's syndrome and adrenal insufficiency following prolonged use of clobetasol cream. Two of the children continued with hypertension even after discontinuation of clobetasol, and were treated with angiotensin-converting enzyme inhibitors. One of these two children had developed acute renal failure, hypertensive encephalopathy, and permanent visual loss prior to admission. Conclusions: Whenever a cushingoid appearance is accompanied by adrenal insufficiency, the exogenous use of steroids, especially topical creams, should be explored. Hypertension may persist even after cessation of use and may result in life threatening complications. © 2015, Iranian Society of Pediatrics

Influence of zinc incorporation on microstructure of hydroxyapatite to characterize the effect of pH and calcination temperatures

AbstractThis work was focused to study the existence of Zn2+ in structure, chemical composition as well as particle and crystallite size of hydroxyapatite (HAp) to characterize the effect of pH of the solution and calcination temperature. Non-stoichiometric HAp (nHAp) powders containing 4at.% zinc fraction were synthesized via solution–precipitation method. In order to characterize the effect of pH (values: 9 and 10.5) and two calcination temperatures (550 and 1000°C) on chemical composition, molecule internal bonds, particle and crystallite size of the synthesized powders, XRD, EDS, FTIR and SEM techniques were utilized. The results showed that zinc cations could be incorporated in the HAp atomic structure to form low crystalline single phase of nHAP. The pH adjustment to 10.5 caused the formation of powders with smaller particle and crystallite sizes. The results also indicated that calcination temperature up to 1000°C caused decomposition of zinc doped nHAp to β-tri calcium phosphate and tri zinc calcium phosphate phases which are used to control the speed of biodegradation

Investigation of temperature and residual stresses field of submerged arc welding by finite element method and experiments

This article reports on a numerical and experimental investigation to understand and improve computer methods in application of the Goldak model for predicting thermal distribution in submerged arc welding (SAW) of APIX65 pipeline steel. Accurate prediction of the thermal cycle and residual stresses will enable control of the fusion zone geometry, microstructure, and mechanical properties of the SAW joint. In this study, a new Goldak heat source distribution model for SAW is presented first. Both 2D and 3D finite element models are developed using the solution of heat transfer equations in ABAQUS Standard implicit. The obtained results proved that the 2D axi-symmetric model can be effectively employed to simulate the thermal cycles and the welding residual stresses for the test steel. As compared to the 3D analysis, the 2D model significantly reduced the time and cost of the FE computation. The numerical accuracy of the predicted fusion zone geometry is compared to the experimentally obtained values for bead-on-plate welds. The predictions given by the present model were found to be in good agreement with experimental measurements

Altered gene expression and root thebaine production in polyploidized and methyl jasmonate-elicited Papaver bracteatum Lindl

Plant science

Relation of the chondromalatia patellae to proximal tibial anatomical parameters, assessed with MRI

Magnetic resonance imaging (MRI) is a non-invasive highly sensitive tool for diagnosing chondromalacia patellae in the early stages. Many studies have evaluated patellar and trochlear morphology with different radiologic indices. We aimed to assess the discriminative power of tibial, patellar, and femoral indices in MRI for chondromalacia patellae. 100 cases of chondromalacia, as well as 100 age-matched controls among the patients who underwent knee MRI between February 2017 and March 2019, were included. The standard protocol of knee MRI was applied and the diagnosis of chondromalacia was made on MRI findings. Chondromalacia subjects were also classified as grade 1 to 4 according to the Modified Outerbridge's MRI grading system. We measured 25 MRI parameters in the knee and adjacent structures to determine the relation between chondromalacia patellae and anatomical MRI parameters. Tibial slope, trochlear depth, lateral trochlear inclination, and lateral patellar tilt angle had significant correlation with chondromalacia. Any increase in lateral trochlear inclination and lateral patellar tilt angle could increase the probability of the disease (Odds ratio OR 1.15, 1.13; 95% CI: 1.03-1.30; 1.02-1.26, respectively), while any increase in medial tibial slope and trochlear depth could decrease the probability of chondromalacia (OR 0.85, 0.06; 95% CI: 0.73-0.98, 0.02-0.17, respectively). We also designed a model for the severity of disease by using the patellar height index (relative odds ratio: 75.9). The result of this study showed the novelty role of tibial anatomy in developing chondromalacia and its mechanism. We also concluded that patellar height might be an important factor in defining disease severity. © 2020 2020 Mohammadreza Tabary, Azadehsadat Esfahani, Mehdi Nouraie, Mohammad Reza Babaei, Ali Reza Khoshdel, Farnaz Araghi, Mostafa Shahrezaee, published by Sciendo

The effect of miRNA mimic hsa-miR-7704 on in-vitro replication of herpes simplex virus type 1

Background: Herpes simplex virus type 1 (HSV-1) infections are of the most common diseases in human population. HSV-1 can cause subclinical to severe diseases, especially in immunocompromised patients. There are few anti-herpes drugs for treatment of HSV-1 infection. Acyclovir is one of the most important drugs. The extensive use of this drug has led to the development of resistant strains. Therefore, development of new anti-herpes drugs with different mechanisms is noticeable. This study aimed to use microRNAs as a novel method for inhibiting HSV-1 infection. Methods: Synthesized miRNA mimics hsa-miR-7704 (miR-SX1) were transfected into Hela cells, and then infected with HSV-1. Cellular morphological changes were observed 24 hours post-infection by inverted microscope, and photographed. Viral titers were measured using 50 tissue culture infective dose (TCID 50 ) method. Findings: miR-SX-1-transfected cells produced low-titer HSV-1, without affecting cell viability. Conclusion: The data suggest that miR-SX1 inhibits HSV-1 replication, and may provide an alternative mechanism to prevent HSV-1 infection. © 2018, Isfahan University of Medical Sciences(IUMS). All rights reserved

Association of Zinc, Copper and Magnesium with bone mineral density in Iranian postmenopausal women - a case control study

Background: The risk of inadequate nutrition such as trace elements and vitamin deficiencies is considerable in postmenopausal women. The aim of this study was to compare trace elements (Zinc, Copper and Magnesium) concentration in nail, urine and serum among osteoporotic postmenopausal women with control group in Iran.Methods: Forty eight postmenopausal women aged 36-60 years, were recruited, consisting 30 osteoporotic patients and 18 healthy controls. Blood, nail and urine concentration of Zinc (Zn), copper (Cu) and magnesium (Mg) were determined using Inductively Coupled Plasma -Atomic Emission Spectrometry (ICP-AES) method. Their Bone Mineral Density was measured by Dual X-ray Absorption (DEXA) method.Results: The urine level of trace elements had significant difference between osteoporotic groups and controls (p < 0.001). Moreover Mg level significantly differed in serum between two groups (p < 0.04). There was no statistically significant difference in trace minerals in nail beyond groups.Conclusion: Our findings indicate that Urine Zn level could be considerable an appropriate marker for bone absorption, usage of Zn supplements in postmenopausal women may result a beneficial reduction in osteoporotic risk. © 2014 Razmandeh et al.; licensee BioMed Central Ltd

Intravitreal injection of anti-vascular endothelial growth factor agents for ocular vascular diseases: Clinical practice guideline

Purpose: To provide the clinical recommendations for the administration of intravitreal anti-vascular endothelial growth factor (VEGF) drugs especially bavacizumab for ocular vascular diseases including diabetic macular edema, neovascular age-related macular degeneration, myopic choroidal neovascularization, retinal vein occlusion and central serous chorioretinopathy. Methods: Twenty clinical questions were developed by the guideline technical committee. Relevant websites and databases were searched to find out the pertinent clinical practice guidelines to answer the questions. The technical committee provided possible answers (scenarios) according to the available evidences for each question. All scenarios along with their levels of evidence and the supported articles were sent to the experts for external review. If the experts did not agree on any of the scenarios for one particular clinical question, the technical committee reviewed all scenarios and their pertinent evidences and made the necessary decision. After that, the experts were asked to score them again. All confirmed scenarios were gathered as the final recommendations. Results: All the experts agreed on at least one of the scenarios. The technical committee extracted the agreed scenario for each clinical question as the final recommendation. Finally, 56 recommendations were developed for the procedure of intravitreal anti-VEGF injection and their applications in the management of ocular vascular diseases. Conclusion: The implementation of this guideline can standardize the management of the common ocular vascular diseases by intravitreal injection of anti-VEGF agents. It can lead to better policy-making and evidence-based clinical decision by ophthalmologists and optimal evidence based eye care for patients. © 2018 Journal of Ophthalmic and Vision Research

Intravitreal injection of anti-vascular endothelial growth factor agents for ocular vascular diseases: Clinical practice guideline

Purpose: To provide the clinical recommendations for the administration of intravitreal anti-vascular endothelial growth factor (VEGF) drugs especially bavacizumab for ocular vascular diseases including diabetic macular edema, neovascular age-related macular degeneration, myopic choroidal neovascularization, retinal vein occlusion and central serous chorioretinopathy. Methods: Twenty clinical questions were developed by the guideline technical committee. Relevant websites and databases were searched to find out the pertinent clinical practice guidelines to answer the questions. The technical committee provided possible answers (scenarios) according to the available evidences for each question. All scenarios along with their levels of evidence and the supported articles were sent to the experts for external review. If the experts did not agree on any of the scenarios for one particular clinical question, the technical committee reviewed all scenarios and their pertinent evidences and made the necessary decision. After that, the experts were asked to score them again. All confirmed scenarios were gathered as the final recommendations. Results: All the experts agreed on at least one of the scenarios. The technical committee extracted the agreed scenario for each clinical question as the final recommendation. Finally, 56 recommendations were developed for the procedure of intravitreal anti-VEGF injection and their applications in the management of ocular vascular diseases. Conclusion: The implementation of this guideline can standardize the management of the common ocular vascular diseases by intravitreal injection of anti-VEGF agents. It can lead to better policy-making and evidence-based clinical decision by ophthalmologists and optimal evidence based eye care for patients. © 2018 Journal of Ophthalmic and Vision Research