Comparison of single- and multistage strategies during fenestrated-branched endovascular aortic repair of thoracoabdominal aortic aneurysms

Objective: The aim of this study was to compare outcomes of single or multistage approach during fenestrated-branched endovascular aortic repair (FB-EVAR) of extensive thoracoabdominal aortic aneurysms (TAAAs). Methods: We reviewed the clinical data of consecutive patients treated by FB-EVAR for extent I to III TAAAs in 24 centers (2006-2021). All patients received a single brand manufactured patient-specific or off-the-shelf fenestrated-branched stent grafts. Staging strategies included proximal thoracic aortic repair, minimally invasive segmental artery coil embolization, temporary aneurysm sac perfusion and combinations of these techniques. Endpoints were analyzed for elective repair in patients who had a single- or multistage approach before and after propensity score adjustment for baseline differences, including the composite 30-day/in-hospital mortality and/or permanent paraplegia, major adverse event, patient survival, and freedom from aortic-related mortality. Results: A total of 1947 patients (65% male; mean age, 71 ± 8 years) underwent FB-EVAR of 155 extent I (10%), 729 extent II (46%), and 713 extent III TAAAs (44%). A single-stage approach was used in 939 patients (48%) and a multistage approach in 1008 patients (52%). A multistage approach was more frequently used in patients undergoing elective compared with non-elective repair (55% vs 35%; P < .001). Staging strategies were proximal thoracic aortic repair in 743 patients (74%), temporary aneurysm sac perfusion in 128 (13%), minimally invasive segmental artery coil embolization in 10 (1%), and combinations in 127 (12%). Among patients undergoing elective repair (n = 1597), the composite endpoint of 30-day/in-hospital mortality and/or permanent paraplegia rate occurred in 14% of single-stage and 6% of multistage approach patients (P < .001). After adjustment with a propensity score, multistage approach was associated with lower rates of 30-day/in-hospital mortality and/or permanent paraplegia (odds ratio, 0.466; 95% confidence interval, 0.271-0.801; P = .006) and higher patient survival at 1 year (86.9±1.3% vs 79.6±1.7%) and 3 years (72.7±2.1% vs 64.2±2.3%; adjusted hazard ratio, 0.714; 95% confidence interval, 0.528-0.966; P = .029), compared with a single stage approach. Conclusions: Staging elective FB-EVAR of extent I to III TAAAs was associated with decreased risk of mortality and/or permanent paraplegia at 30 days or within hospital stay, and with higher patient survival at 1 and 3 years

Influence of single and binary doping of strontium and lithium on in vivo biological properties of bioactive glass scaffolds

Effects of strontium and lithium ion doping on the biological properties of bioactive glass (BAG) porous scaffolds have been checked in vitro and in vivo. BAG scaffolds were prepared by conventional glass melting route and subsequently, scaffolds were produced by evaporation of fugitive pore formers. After thorough physico-chemical and in vitro cell characterization, scaffolds were used for pre-clinical study. Soft and hard tissue formation in a rabbit femoral defect model after 2 and 4 months, were assessed using different tools. Histological observations showed excellent osseous tissue formation in Sr and Li + Sr scaffolds and moderate bone regeneration in Li scaffolds. Fluorochrome labeling studies showed wide regions of new bone formation in Sr and Li + Sr doped samples as compared to Li doped samples. SEM revealed abundant collagenous network and minimal or no interfacial gap between bone and implant in Sr and Li + Sr doped samples compared to Li doped samples. Micro CT of Li + Sr samples showed highest degree of peripheral cancellous tissue formation on periphery and cortical tissues inside implanted samples and vascularity among four compositions. Our findings suggest that addition of Sr and/or Li alters physico-chemical properties of BAG and promotes early stage in vivo osseointegration and bone remodeling that may offer new insight in bone tissue engineering

The prevalence of serum antibodies in TORCH infections during the first trimester of pregnancy in Kashan, Iran

Background: TORCH infections are caused by Toxoplasma gondii and other microorganisms such as Treponema pallidum, the Rubella virus (RV), Cytomegalovirus (CMV) and the Herpes Simplex Virus (HSV) Type I and II during the first trimester of pregnancy. They might lead to severe fetal anomalies or even fetal loss. The current study aimed to determine the serological data of TORCH infections in women in their first trimester of pregnancy. Methods: This descriptive study was conducted on 80 pregnant women who were in their first trimester in Kashan, Iran. To detect the specific IgM and IgG antibodies against the TORCH infections, sera were collected from these women by ELISA. Results: The specific IgG antibodies were found to be positive for toxoplasmosis in 30 cases (37.5), for the Rubella virus in 74 (92.5), for CMV in 79 (98.8) and for the HSV Type I and II in 73 cases (91.3). Moreover, 3.8 of the cases were found to be seropositive for Toxoplasma IgM antibody (95 CI, 0.38-7.9), 5 were positive for CMV IgM antibody (95 CI, 0.23-9.77) and 7.5 were positive for the HSV IgM antibody (95 CI, 1.8-13.2). Finally, it was observed that 63.8 of the pregnant women were at the risk of at least one of the TORCH agents. Conclusion: This study was indicative of a high prevalence of infections caused by TORCH agents among pregnant women. Therefore, national screening programs are crucial to a routine TORCH screen as well as to preventing and treating congenital TORCH infections

Electrocardiography in Early Diagnosis of Cardiovascular Complications of COVID-19; a Systematic Literature Review

Introduction: Many reports have stated that patients admitted for COVID-19 may also suffer from cardiovascular diseases, suggesting cardiovascular involvement in COVID-19. Since there is direct association between electrocardiography (ECG) data and the prognosis of cardiovascular disease, a systematic literature review was performed in the present study to address this association and make a conclusive agreement on the early diagnostic and prognostic values of ECG in patients with COVID-19. Methods: Electronic databases including PubMed, Scopus, Web of Science, Science Direct, Ovid, Embase, and Google Scholar were searched for �COVID-19� and �ECG� using all their equivalents and similar terms as search words. Afterwards, the records were limited to English articles and irrelevant documents, as well as articles that reported drug-induced cardiac dysfunction or patients with previous history of cardiovascular complications were excluded. Results: Overall, 31 articles with 2379 patients were found and used for qualitative data extraction. Findings showed that there is a significant association between COVID-19 infection and ECG findings. Also, ST-segment changes, T wave inversions, QT prolongation, and atrial fibrillation were found to be early indicators of cardiac involvement of COVID-19, which were associated with worse outcomes. Conclusion: It is recommended to use ECG as a valuable diagnostic and prognostic tool for cardiac evaluation of patients with COVID-19. © 2020. All rights reserved

Effects of kangaroo and routine care on physiologic parameters of low-birth-weight infants

Background and aimLow birth weight (LBW) is the most important indicator of mortality in children. These infants cannot tolerate physiologic stresses; therefore, they are isolated from their mothers to be put in incubators. This isolation put them at numerous risks. This clinical trial was conducted to compare the effects of kangaroo with routine care on physiologic parameters of low-birth-weight infants at NICUs in 2008.Materials and methods80 LBW infants were randomly divided into 2 equal experimental and control groups. In kangaroo-care group, the infants were removed from incubator for 1 hour and put on the chest of their mothers. The control group was provided care routinely. Physiologic parameters including pulse rate, oxygenation of arterial blood, temperature and respiratory rate were checked at 30 and 50 minutes after the return of infants to their incubators. Data collection form was validated by content method and validities of instruments were checked by choosing standard and authorized devices. Reliability was achieved by inter-rater method (r=0.87). FindingsNo significant difference was found between the 2 methods during care in terms of the parameters (P>0.05). However, a significant difference was found between pulse rate as well as oxygenation changes 5 and 50 minutes after care delivery (P=0.01, P=0.02 and P=0.03) with no difference in temperature (P=0.48). Conclusion Findings showed that Kangaroo care is as effective as routine care in stability of physiologic parameters. Therefore, developing educational programs for healthcare personnel, nurses and mothers can facilitate the provision of this type of care.Keywords: Physiologic parameters, Low-birth-weight infants, Kangaroo care, Routine care,                   Neonatal intensive care units (NICUs).   *Corresponding Author: Nurian, M; Dept. of Pediatrics, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences . Tehran, Iran. E-mail: [email protected]

Probiotic plus low-calorie diet increase gene expression of Toll-like receptor 2 and FOXP3 in overweight and obese participants

We evaluated the effects of probiotic supplementation with a low-calorie diet on the gene expression of mediators of the immune system among overweight and obese individuals; participants were randomly divided into three groups of 25 each: group 1 consumed conventional yogurt with a low-calorie diet (CLCD); group 2 consumed probiotic yogurt with a low-calorie diet (PLCD) and group 3 consumed probiotic yogurt without a low-calorie diet (PWLCD) for 8 weeks. Probiotic yogurt contained Lactobacillus acidophilus LA5, Lactobacillus casei DN001, Bifidobacterium lactis Bb12 and Streptococcus thermophiles (108 CFU/mL each). Quantitative results of RT-PCR demonstrated that there was an increase in the gene expression of toll like receptor 2(TLR2) in PLCD group compared to CLCD and PWLCD groups (2.7 ± 2.8 vs. 0.9 ± 0.8, 1.9 ± 1.6, respectively, P = 0.001) as well as an increase in FOXP3 gene in PLCD group compared to the other groups (11.2 ± 6.7 vs. 6 ± 2.5, 6.3 ± 1.9, respectively, P &lt; 0.001). Our study demonstrated that the 8-week consumption of PLCD among overweight and obese individuals resulted in a significant up-regulation in the expression of the TLR2. © 2018 Elsevier Lt

Probiotic plus low-calorie diet increase gene expression of Toll-like receptor 2 and FOXP3 in overweight and obese participants

Abstract We evaluated the effects of probiotic supplementation with a low-calorie diet on the gene expression of mediators of the immune system among overweight and obese individuals; participants were randomly divided into three groups of 25 each: group 1 consumed conventional yogurt with a low-calorie diet (CLCD); group 2 consumed probiotic yogurt with a low-calorie diet (PLCD) and group 3 consumed probiotic yogurt without a low-calorie diet (PWLCD) for 8 weeks. Probiotic yogurt contained Lactobacillus acidophilus LA5, Lactobacillus casei DN001, Bifidobacterium lactis Bb12 and Streptococcus thermophiles (108 CFU/mL each). Quantitative results of RT-PCR demonstrated that there was an increase in the gene expression of toll like receptor 2(TLR2) in PLCD group compared to CLCD and PWLCD groups (2.7 ± 2.8 vs. 0.9 ± 0.8, 1.9 ± 1.6, respectively, P = 0.001) as well as an increase in FOXP3 gene in PLCD group compared to the other groups (11.2 ± 6.7 vs. 6 ± 2.5, 6.3 ± 1.9, respectively, P < 0.001). Our study demonstrated that the 8-week consumption of PLCD among overweight and obese individuals resulted in a significant up-regulation in the expression of the TLR2. Keywords: Probiotic Obesity Gene expression Toll like receptor 2 Nuclear factor kappa

Green synthesis and evaluation of silver nanoparticles as adjuvant in rabies veterinary vaccine

Vahid Asgary,1,2 Alireza Shoari,1 Fahimeh Baghbani-Arani,3 Seyed Ataollah Sadat Shandiz,4 Mohammad Sadeq Khosravy,5 Alireza Janani,1 Razieh Bigdeli,6 Rouzbeh Bashar,1 Reza Ahangari Cohan1,7 1Virology Research Group, Department of Rabies, Pasteur Institute of Iran, 2Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, 3Department of Genetics and Biotechnology, School of Biological Science, Varamin-Pishva Branch, Islamic Azad University, Varamin, 4Young Researchers and Elite Club, East Tehran Branch, Islamic Azad University, 5Department of Laboratory of Animal Sciences, Pasteur Institute of Iran, 6Department of Genetic, Science and Research Branch, Islamic Azad University, 7New Technologies Research Group, Department of Pilot Nanobiotechnology, Pasteur Institute of Iran, Tehran, Iran Background: Green synthesis of nanoparticles by plant extracts plays a significant role in different applications. Recently, several studies were conducted on the use of nanoparticles as adjuvant. The main aim of this study was to evaluate green synthesized silver nanoparticles (AgNPs) as adjuvant in rabies veterinary vaccine and compare the results with the existing commercially available alum adjuvant.Materials and methods: In the current study, AgNPs were prepared by the reduction of aqueous silver nitrate by leaf extract of Eucalyptus procera. The formation of AgNPs was confirmed by ultraviolet (UV)&ndash;visible spectrophotometer, scanning electron microscopy, dynamic light scattering, and X-ray diffraction analysis. Then, different amounts of AgNPs (200&nbsp;&micro;g, 400&nbsp;&micro;g, 600&nbsp;&micro;g, and 800&nbsp;&micro;g) were added to 1&nbsp;mL of inactivated rabies virus. The loaded vaccines (0.5&nbsp;mL) were injected intraperitoneally into six Naval Medical Research Institute mice in each group on days 1 and 7. On the 15th day, the mice were intracerebrally challenged with 0.03&nbsp;mL of challenge rabies virus (challenge virus strain-11, 20 lethal dose [20 LD50]), and after the latency period of rabies disease in mice (5&nbsp;days), the mice were monitored for 21&nbsp;days. Neutralizing antibodies against rabies virus were also investigated using the rapid fluorescent focus inhibition test method. The National Institutes of Health test was performed to determine the potency of optimum concentration of AgNPs as adjuvant. In vitro toxicity of AgNPs was assessed in L929 cell line using MTT assay. In addition, in vivo toxicity of AgNPs and AgNPs-loaded vaccine was investigated according to the European Pharmacopeia 8.0.Results: AgNPs were successfully synthesized, and the identity was confirmed by UV&ndash;visible spectrophotometry and X-ray diffraction analysis. The prepared AgNPs were spherical in shape, with an average size of 60&nbsp;nm and a negative zeta potential of -14&nbsp;mV as determined by dynamic light scattering technique. The highest percentage of viability was observed at 15&nbsp;mg/kg and 20&nbsp;mg/kg of AgNPs-loaded vaccine concentrations after injecting into the mice. The calculated potencies for alum-containing vaccine and AgNPs-loaded vaccine (dose 15&nbsp;mg/kg) were 1.897 and 1.303, respectively. MTT assay demonstrated that alum at the concentration of 10&nbsp;mg/mL was toxic, but AgNPs were not toxic. The in vivo toxicity also elucidated the safety of AgNPs and AgNPs-loaded vaccine in mice and dogs, respectively.Conclusion: In the current study, for the first time, the adjuvanticity effect of green synthesized AgNPs on veterinary rabies vaccine potency with no in vivo toxicity was elucidated according to the European Pharmacopeia 8.0. Keywords: green synthesis, nanoparticles, rabies virus, adjuvan