Different sonographic features of peripheral thyroid nodule calcification and risk of malignancy : a prospective observational study

Purpose: To investigate the association of peripheral calcification, as well as its sonographic features, with thyroid nodule malignancy. Material and methods: This study was prospectively conducted during 2015-2020 on patients diagnosed with thyroid nodule undergoing ultrasound-guided fine-needle aspiration in Shahid Beheshti teaching hospital or private offices in Babol, northern Iran. The ultrasonographic characteristics of the nodules, as well as the cytological findings, were recorded. Regression analysis was used to assess the relationship between sonographic results and malignancy. We also used receiver operator characteristics (ROC) analysis to estimate the ability of ultrasound to predict the characteristic features of malignancy, as estimated by the area under the curve (AUC). Results: A total of 1857 thyroid nodules were finally included, of which 84 were peripherally calcified nodules. There was a significant positive association between the nodule malignancy and peripheral calcification (OR = 2.23, 95% CI: 1.13-4.35). In the nodules with peripheral calcification, significant positive associations were seen between malignancy and lobulated margin (OR = 3.85, 95% CI: 1.02-14.54) and solid composition (OR = 4.05, 95% CI: 0.99-16.53). The ROC analysis indicated that AUC for lobulated margin and solid composition was 63.8% and 66.5%, respectively, in predicting malignant thyroid nodules. Conclusion: The findings showed that peripheral calcification on sonography can be a potential indicator of malignant thyroid nodules. Also, the presence of lobulated margin and/or solid composition, besides peripheral calcification, can be helpful in better distinguishing malignant from benign nodules

The influence of social comparison on the perception of quality of life amongst people living with epilepsy in Iran and the United Kingdom

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University London.Epileptic seizures are usually stressful episodes for individuals, not least as they are often experienced in public. Most research into epilepsy has been conducted in Western cultures, and we know little about the experiences of people with epilepsy and living in Middle Eastern countries. This study aims to examine the influence of social comparison on the perception of quality of life for people with epilepsy in Iran and in the United Kingdom. Three studies were completed. Two studies were qualitative; exploring individuals’ experiences of living with epilepsy and investigating coping strategies, respectively, (UK = 10, Iran = 10), for each study. Thematic analysis was used for data analysis. The third quantitative study was examined to determine whether social comparison dimensions, (upward negative, upward positive, downward negative, downward positive), predict quality of life in both countries, (N = 100 for each country), and a hierarchical multiple regression was used to analyse data. The first study indicated people compare themselves to others and the unpredictable nature of a seizure causes individuals to perceive negative feelings and experience anxiety, furthermore urinary incontinence attached to seizures appeared to leave people feeling ashamed and anxious. Study two revealed that whilst Iranian people used emotion-focused coping strategies, individuals from the United Kingdom applied problem-focused coping strategies. In Iran religious coping strategies were used to cope with incontinency; however positive social comparison (downward) was used as a coping strategy for incontinency in the United Kingdom. Study three found that self-esteem was the main predictor for quality of life in Iran and the United Kingdom. Whilst a seizure’s severity negatively predicts quality of life in the United Kingdom, positive social comparison (upward) accounted for quality of life in Iran. This study suggests that providing positive role models can help Iranians have a better perception for their quality of life, whereas British people potentially maximise their quality of life through seizure management

Considering lactate dehydrogenase (LDH) concentration in nasal-wash (NW) as a marker in evaluating the outcome of patients with bronchiolitis

Background: Estimation of bronchiolitis severity in infants is still an important issue and there are no standard methods to help physicians for better evaluation and management of clinical status of these patients. The aim of this study was to investigate the role LDH concentration in NW as a biomarker in evaluation the outcome of patients suffering bronchiolitis in Bu Ali Hospital, Ardabil.Methods: 100 children with bronchiolitis aged below 2 years entered the study. Nasal wash sample was extracted from all patients using 2 ml of normal saline. Samples were sent to laboratory to measure LDH level. Data were analyzed by statistical methods in SPSS.16.Results: The mean age of patients was 6.9±3.7 months and 57% of them were male. 42% of patients had mild bronchiolitis and 58% of them suffered from severe bronchiolitis. The LDH level of nasal wash fluid was neither related with gender nor with age. But it was significantly lower in patients who required oxygen therapy and had fever compared with those who did not require oxygen therapy and without fever. Moreover, LDH level showed a significant negative association with hospital stay (r= -0.570, p<0.001) and bronchiolitis severity (r= -0.440, p<0.001) in a way that its concentration was significantly lower in patients with hospital stay longer than 24 hours compared with hospital stay shorter than 24 hours, and in patients with severe bronchiolitis compared with mild bronchiolitis.Conclusions: According to results of this study, LDH measurement in nasal wash fluid can be used as a biochemical marker to evaluate clinical outcomes of bronchiolitis in children younger than 24 months

Levels of anxiety and depression as predictors of mortality following myocardial infarction: A 5-year follow-up

Background: Post-myocardial infarction (MI) depression is a highly prevalent disorder, affec­ting nearly 18% of all MI patients, and it is a major predictor of disability in the year post-MI. We sought to expand this analysis by: comparing case-level anxiety, depression, and comorbid anxiety and depression as predictors of long term mortality during a 5-year follow-up period after MI; and investigating the role of potential modifying and confounding factors. Methods: A total of 285 patients were screened on average 6 days after their MI and a 5-year survival rate was ascertained. The Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI) were completed by patients hospitalized for MI. In addition we tested the BDI × STAI interaction effect. Results: During the 5 years of follow-up, cardiac mortality was assessed in 274 of 285 eligible patients. Of the 274 patients whose survival data were available, 91 (33.2%) died. At entry, BDI score of 192 (67.4%) patients was ≥ 10 and 145 (50.9%) patients had STAI score ≥ 40. Anxiety was not associated with mortality, whereas depression significantly predicted death, but this association was attenuated to non-significance with full adjustment with disease severity and confounders. Conclusions: Depression following MI does not predict longer-term survival with full adjustment.

Shape optimisation of concrete open spandrel arch bridges

U ovom se radu analizira lučni most s otvorenim nadlučnim sklopom. Računalni kod je izveden za izradu modela na temelju geometrijskih podataka, a radi rješavanja problema optimalizacije. U ovom se radu provodi postupak optimalnog projektiranja, a ukupan obujam materijala ugrađenog u donji ustroj mosta usvaja se kao objektivna funkcija. Donji ustroj sadrži stup i armiranobetonski luk. Na kraju je proveden i postupak optimalizacije pomoću algoritma za istovremeno stohastičko predviđanje poremećaja.An open spandrel arch bridge is analysed in this paper. A computer code is written to create a model from geometrical data, so as to solve the optimisation problem. An optimum design procedure is conducted in the paper, and the total material volume of the bridge substructure is adopted as an objective function. The substructure includes the column and the reinforced-concrete arch. Finally, the optimization technique is implemented using the Simultaneous Perturbation Stochastic Approximation algorithm

Evaluation of the relation between poverty and health-related quality of life in the people over 60 years-old in the district 4 of Tehran municipality in 2009-2010

Please cite this article as: Heidarnia MA, Ghaemian T, Montazeri A, Abadi AR. Evaluation of the relation between poverty and health-related quality of life in the people over 60 years-old in the district 4 of Tehran municipality in 2009-2010. Novel Biomed 2013;1:23-28.As the articles in recent years well indicate, more than all other factors, social determinants of health are involved in people's health status and quality of life (QOL). Among these social factors, the economic one is introduced as the main factor determining health status. This study was designed to evaluate the impact of poverty on QOL. The health-related QOL of poor people under coverage of a public charity institution (group 1) was compared with the QOL of ordinary people (group2) using the SF-36 questionnaire. The QOL scores in the groups 1 and 2 were analyzed by Mann-Whitney, Kruskal -Wallis tests and logistic regression using the SPSS 16.00 software. A total of 400 individuals were studied. The results showed significant differences between the two groups in the QOL measures of SF-36, except for physical and mental health measures (P&lt;0.001). With regard to the adverse consequence of the Physical Component Scale (PCS), employing logistic regression analysis, statistically significant relationships between the two groups in the demographic characteristics, except age and marital status, were found. For the adverse consequence of Mental Component Scale (MCS), logistic regression showed statistically significant differences between the two groups in the demographic characteristics, except for age. The findings indicate that poverty diminishes the QOL in most aspects; however, considering all aspects of QOL is necessary to promote the individuals' health

Diagnostic value of myocardial perfusion scans for diagnosis of coronary artery disease

زمینه و هدف: بیماری های عروق کرونر موجب مرگ و میر، ناتوانی و تحمیل هزینه های زیادی می شود. ارزش تشخیصی اسکن قلب برای تنگی عروق کرونر متفاوت گزارش شده است. هدف این مطالعه بررسی ارزش تشخیصی اسکن در مقایسه با آنژیوگرافی است. روش بررسی: این مطالعه از نوع مقطعی بوده و جامعه آماری بیماران مراجعه کننده به بخش پزشکی هسته ای بیمارستان قلب ساری بودند. 115 بیمار که نتیجه آنژیوگرافی آن ها معلوم بود انتخاب شدند. داده های مربوط به عوامل خطر بیماری عروق کرونر به وسیله پرسش نامه، جمع آوری گشت. نتایج با استفاده از آزمون t و کای اسکور با SPSS و استفاده از شاخص های حساسیت و ویژگی و ارزش پیشگویی مثبت و منفی مقایسه شدند. یافته ها: 62 نفر (9/53) زن و میانگین و انحراف معیار سن بیماران 67/9&plusmn;85/56 سال بود که در گروه نرمال و گروه مبتلا به بیماری عروق کرونر اختلاف معنی دار داشته است (001/0&gt;P). فراوانی سایر عوامل خطرزا به ترتیب فشارخون بالا (7/55)، سابقه خانوادگی بیماری قلبی (1/46) و دیابت (33) به دست آمد. بین فشارخون سیستولیک، کلسترول، HDL، LDL، تری گلیسیرید و شاخص توده بدنی با نتیجه آنژیوگرافی ارتباط آماری معنی داری مشاهده نشد. حساسیت اسکن پرفیوژن میوکارد قلب در تشخیص بیماری عروق کرونر در مقایسه با آنژیوگرافی برابر با 84 و ویژگی آن برابر 92 به دست آمد؛ همچنین ارزش پیشگویی کننده مثبت 5/95 و ارزش پیشگویی کننده منفی 75 محاسبه شد. نتیجه گیری: با توجه به نتایج این مطالعه و بالا بودن میزان حساسیت و ویژگی اسکن پرفیوژن میوکارد در مقایسه با آنژیوگرافی، اسکن پرفیوژن میوکارد به عنوان روشی غیر تهاجمی در تشخیص تنگی عروق کرونر کمک کننده می باشد؛ ولی باید شرایط انتخاب بیماران استاندارد و بدون اوریبی در انتخاب باشد