28 research outputs found
Extending Survival in a Patient with Extensive Stage of Small Cell Lung Cancer Presenting with Superior Vena Cava Syndrome as an Initial Symptom: A Case Study
Introduction: Superior vena cava (SVC) syndrome which is defined as the obstruction of blood flow through the SVC vein, often affecting patients with malignancy especially small cell lung cancer (SCLC) and is potentially an emergent condition needing prompt management. It is an ominous sign with poor prognosis and a mean of 8-10 months survival rate. Case presentation: Here we present a middle-aged man who presented with fascial swelling and dyspnea with final diagnosis of advanced SCLC. Combination of multiple chemotherapy regimen, prophylactic brain radiation with administration of anticoagulant drugs were performed for him leading toward extension of his survival to 28 months. Conclusion: These therapeutic approaches may lead to extending the survival in patients with SVC syndrome and SCLC
The Effect of Cognitive Behavioral Therapy on Postpartum Depression: A Review and Meta-Analysis Study
Background: Mother's health and breastfeeding efficacy are affected by depression during pregnancy. The aim of study was to determine the effects of cognitive-behavioral therapy on the treatment of postpartum depression in mothers after childbirth.
Methods: In this systematic review, the Web of Sciences, PubMed, Scopus, Google Scholar, Iran Medex, Magiran & SID databases were used to access relevant documentation. To search for articles in the resource, the keywords depression AND cognitive-behavior therapy AND "perinatal OR antepartum OR childbirth" is used with all possible combinations of these words. Without time limitation, all related articles have been retrieved. Search was restricted to articles published in Persian and English. The quality of papers was examined using the Cochran risk of bias tool. Meta-analysis was performed using Rev 5.3.
Results: We retrieved 621 titles, of which 12 were qualified after the qualitative synthesis. Meta-analysis revealed a statistically significant beneficial effect of CBT sessions as compared to routine postpartum care on long term management of postpartum depression. (Mean Difference: -4.02 [-5.58, -2.47]). A pooled effect size with BID instrument was observed -6.32 [-8.54, -4.11] at 3 months, with EPDS were observed -2.83 [-6.56, 0.90] and -2.81 [-4.21, -1.41] at 3 and 6 months respectively.
Conclusions: CBT was shown to be effective however the evidence available is limited. It can be used as an effective psychological treatment without the side effect of drugs in PPD.
Keywords: Postpartum depression, Cognitive behavioral therapy, Psychological disorder, Review, Meta-analysis
Extending Survival in a Patient with Extensive Stage of Small Cell Lung Cancer Presenting with Superior Vena Cava Syndrome as an Initial Symptom: A Case Study
Introduction: Superior vena cava (SVC) syndrome which is defined as the obstruction of blood flow through the SVC vein, often affecting patients with malignancy especially small cell lung cancer (SCLC) and is potentially an emergent condition needing prompt management. It is an ominous sign with poor prognosis and a mean of 8-10 months survival rate. Case presentation: Here we present a middle-aged man who presented with fascial swelling and dyspnea with final diagnosis of advanced SCLC. Combination of multiple chemotherapy regimen, prophylactic brain radiation with administration of anticoagulant drugs were performed for him leading toward extension of his survival to 28 months. Conclusion: These therapeutic approaches may lead to extending the survival in patients with SVC syndrome and SCLC
Evaluating Patients with Olfactory Dysfunction after COVID-19 Infection by Questionnaire of Olfactory Disorders-Negative Statements
Background: The number of patients with COVID-19-induced olfactory dysfunction has consistently increased since the onset of the pandemic. Since a considerable proportion of these patients have olfactory dysfunction for a relatively long period of time, their quality of life (QOL) may considerably be impacted as a result.
Aim: The aim of the present study was to investigate the adverse effects of olfactory dysfunction on QOL in patients with COVID-19-induced hyposmia or anosmia.
Methods: The data were obtained via self-reported online questionnaire in individuals who met the inclusion criteria. The questionnaire included demographics, olfactory status and Questionnaire of Olfactory Disorders-Negative Statements (QOD-NS).
Results: Among1531 participants, 1072 individuals met the inclusion criteria, with 588 (54.85%) having hyposmia and 484 (45.15%) anosmia. Average age was 35.7 in the hyposmic group and 34.5 in the anosmic group. Concurrent hypogeusia/ageusia was reported in 398 (67.7%) of cases with hyposmia and in 346 (71.5%) of participants with anosmia. Lack of enjoyment of eating food was the most negative effect in both hyposmic and anosmic groups, followed by annoyance when eating food and a continuous awareness of the olfactory problem. The mean QOD-NS score was 20.5±10.2 in the hyposmic group and 23.3±10.4 in the anosmic group, demonstrating significant adverse impact on QOL.
Conclusion: Persistent olfactory dysfunction in patients with COVID-19 has adverse effects on QOL. Early diagnosis and treatment of olfactory dysfunction may be crucial in limiting the adverse impact on QOL by psychological and nutritional support and olfactory rehabilitation
Neuromodulation in the Age of Modern Neuroimaging Technologies
Most commonly used for the treatment of Parkinson’s disease (PD), the deep brain stimulation (DBS) is a new neurosurgical method whose other applications are still under development. Neuroimaging has a variety of main roles in DBS including evaluating the final electrode contact position, localizing the target nucleus, and detecting complications. Despite being a neurosurgical method, successful DBS intervention is highly dependent on an appropriate neuroimaging technique. For achieving satisfying clinical results, DBS needs the presence of neuroradiologists. In this chapter, we have reviewed the role of neuroimaging in all stages of deep brain stimulation as well as the underlying mechanism in this domain
Evaluating the Effects of Umifenovir Compared to Lopinavir/Ritonavir in the Management of Patients with COVID-19: A Randomized Controlled Trial
Background. Due to the lack of specific safe medications for the treatment of COVID-19, medications used for other similar conditions are being tested to alleviate the condition of COVID-19 patients, resulting in acceptable outcomes in some cases. Umifenovir (Arbidol®) is used to treat influenza viruses by inhibiting the fusion of the virus with the host cell. According to previous findings, umifenovir may inhibit SARS-CoV-2 infection by interfering with the release of SARS-CoV-2 from inside the cell. This study aimed to determine the effects of umifenovir, a fusion inhibitor, versus lopinavir/ritonavir in treating patients with COVID-19. Methods. This study was a randomized controlled trial consisting of 90 confirmed COVID-19 patients divided into the lopinavir/ritonavir group and the umifenovir group. The lopinavir/ritonavir group received 100/25 mg twice, while the umifenovir group was given 200 mg thrice a day, in both groups, for seven days. Outcomes included mortality rate and the need for mechanical ventilation or intensive care unit admission. Length of stay in the hospital and ICU and the lab tests trend were also assessed. Results. The mortality rate and the need for admission to the ICU were significantly lower in the umifenovir group (8% vs. 27.5%; P-value = 0.02). Moreover, The levels of white blood cells were also lower in the umifenovir group than in the control group by day 10 (6.2 (5.3-7.4) vs. 10.8 (9.9-13); P-value <0.001). Conclusions. Umifenovir may reduce the need for admission to the ICU and mortality rate in patients with COVID-19 compared with lopinavir/ritonavir. The lab test trends were also in favor of umifenovir use.
Mendelian gene identification through mouse embryo viability screening.
BACKGROUND: The diagnostic rate of Mendelian disorders in sequencing studies continues to increase, along with the pace of novel disease gene discovery. However, variant interpretation in novel genes not currently associated with disease is particularly challenging and strategies combining gene functional evidence with approaches that evaluate the phenotypic similarities between patients and model organisms have proven successful. A full spectrum of intolerance to loss-of-function variation has been previously described, providing evidence that gene essentiality should not be considered as a simple and fixed binary property.
METHODS: Here we further dissected this spectrum by assessing the embryonic stage at which homozygous loss-of-function results in lethality in mice from the International Mouse Phenotyping Consortium, classifying the set of lethal genes into one of three windows of lethality: early, mid, or late gestation lethal. We studied the correlation between these windows of lethality and various gene features including expression across development, paralogy and constraint metrics together with human disease phenotypes. We explored a gene similarity approach for novel gene discovery and investigated unsolved cases from the 100,000 Genomes Project.
RESULTS: We found that genes in the early gestation lethal category have distinct characteristics and are enriched for genes linked with recessive forms of inherited metabolic disease. We identified several genes sharing multiple features with known biallelic forms of inborn errors of the metabolism and found signs of enrichment of biallelic predicted pathogenic variants among early gestation lethal genes in patients recruited under this disease category. We highlight two novel gene candidates with phenotypic overlap between the patients and the mouse knockouts.
CONCLUSIONS: Information on the developmental period at which embryonic lethality occurs in the knockout mouse may be used for novel disease gene discovery that helps to prioritise variants in unsolved rare disease cases
Comprehensive ECG reference intervals in C57BL/6N substrains provide a generalizable guide for cardiac electrophysiology studies in mice.
Reference ranges provide a powerful tool for diagnostic decision-making in clinical medicine and are enormously valuable for understanding normality in pre-clinical scientific research that uses in vivo models. As yet, there are no published reference ranges for electrocardiography (ECG) in the laboratory mouse. The first mouse-specific reference ranges for the assessment of electrical conduction are reported herein generated from an ECG dataset of unprecedented scale. International Mouse Phenotyping Consortium data from over 26,000 conscious or anesthetized C57BL/6N wildtype control mice were stratified by sex and age to develop robust ECG reference ranges. Interesting findings include that heart rate and key elements from the ECG waveform (RR-, PR-, ST-, QT-interval, QT corrected, and QRS complex) demonstrate minimal sexual dimorphism. As expected, anesthesia induces a decrease in heart rate and was shown for both inhalation (isoflurane) and injectable (tribromoethanol) anesthesia. In the absence of pharmacological, environmental, or genetic challenges, we did not observe major age-related ECG changes in C57BL/6N-inbred mice as the differences in the reference ranges of 12-week-old compared to 62-week-old mice were negligible. The generalizability of the C57BL/6N substrain reference ranges was demonstrated by comparison with ECG data from a wide range of non-IMPC studies. The close overlap in data from a wide range of mouse strains suggests that the C57BL/6N-based reference ranges can be used as a robust and comprehensive indicator of normality. We report a unique ECG reference resource of fundamental importance for any experimental study of cardiac function in mice
The Effect of Cognitive Behavioral Therapy on Postpartum Depression: A Review and Meta-Analysis Study: cognitive behavioral therapy on postpartum depression
Background: Mother's health and breastfeeding efficacy are affected by depression during pregnancy. The aim of study was to determine the effects of cognitive-behavioral therapy on the treatment of postpartum depression in mothers after childbirth.
Methods: In this systematic review, the Web of Sciences, PubMed, Scopus, Google Scholar, Iran Medex, Magiran & SID databases were used to access relevant documentation. To search for articles in the resource, the keywords depression AND cognitive-behavior therapy AND "perinatal OR antepartum OR childbirth" is used with all possible combinations of these words. Without time limitation, all related articles have been retrieved. Search was restricted to articles published in Persian and English. The quality of papers was examined using the Cochran risk of bias tool. Meta-analysis was performed using Rev 5.3.
Results: We retrieved 621 titles, of which 12 were qualified after the qualitative synthesis. Meta-analysis revealed a statistically significant beneficial effect of CBT sessions as compared to routine postpartum care on long term management of postpartum depression. (Mean Difference: -4.02 [-5.58, -2.47]). A pooled effect size with BID instrument was observed -6.32 [-8.54, -4.11] at 3 months, with EPDS were observed -2.83 [-6.56, 0.90] and -2.81 [-4.21, -1.41] at 3 and 6 months respectively.
Conclusions: CBT was shown to be effective however the evidence available is limited. It can be used as an effective psychological treatment without the side effect of drugs in PPD.
Keywords: Postpartum depression, Cognitive behavioral therapy, Psychological disorder, Review, Meta-analysis
WalnĂĽsse - Anbau, Ernte und Verarbeitung bei kleinen Produktionsmengen
Auf vielen landwirtschaftlichen Betrieben stehen vereinzelt Walnussbäume, in der Schweiz Baumnüsse genannt. Auch mit den damit verbundenen kleinen Erntemengen können Landwirtschaftsbetriebe ihr Hofprodukteangebot ergänzen. Die richtige Trocknung, Weiterverarbeitung und Lagerung ist in jedem Fall entscheidend für eine erfolgreiche Vermarktung und eine einwandfreie Produktqualität