Mesenchymal Stem Cells and the Prospect of its Application in the Treatment of stroke

Despite extensive medical advances, stroke is still one of the major problems in health care system. Researchers are seeking novel therapeutic strategies for the treatment of stroke, such as cell-therapy. In this regard, mesenchymal stem cells are the most used cells in stroke cell-therapy researches. Mesenchymal stem cells are multipotent cells capable of self-renewal and differentiation, which can be derived from various tissues, such as bone marrow, skeletal muscle, adipose tissue, umbilical cord, and synovium. In this review article, after description of mesenchymal stem cells, the studies related to use of these cells in stroke as well as the challenges ahead in the field of stroke cell therapy, were mentioned. According to existing studies, although it seems that use of mesenchymal stem cells transplantation has a bright prospect in the treatment of stroke, there are still some issues, such as apoptosis of grafted cell, neural differentiation of stem cell, likelihood of malignancy of transplanted cell, unwanted cell differentiation, and migration to ischemic region, have overshadowed its clinical application

Effect of combination fluoxetine and exercise on prefrontal BDNF, anxiety-like behavior and fear extinction in a female rat model of post-traumatic stress disorder (PTSD): a comparison with male animals

Abstract Despite significant differences between men and women in the symptoms of PTSD and the response to therapeutic interventions, most PTSD studies have been done on male subjects. Continuing our previous study in male rats, this study aimed at better understanding the effect of a combination therapy of exercise with fluoxetine on female PTSD rats. The results were then compared with our past findings in male animals. Female adult Wistar rats subjected to PTSD were treated with moderate treadmill exercise or fluoxetine, or a combination of both. PTSD was induced by the single prolonged stress (SPS) model. Elevated plus-maze (EPM), serum and prefrontal BDNF, and fear extinctions were evaluated. The results showed that exercise plus fluoxetine decreased anxiety-like behavior, improved fear extinction, and increased BDNF changes in female rats. The effects of exercise alone were comparable with those of combination therapy except that combination therapy was more effective on OAT (open arm entry). The majority of results in female rats, except for those of prefrontal BDNF, 4th extinction, and OAT, were similar to those of male rats as shown in our previous study. According to our findings, exercise as a safe and cost-effective intervention can be considered as a complementary efficient option for PTSD treatment in both sexes. To achieve better treatment outcomes in PTSD patient, considering sex differences is recommended

Thyroid hormones and stroke, the gap between clinical and experimental studies

Despite plenty of human studies on changes in thyroid hormones after stroke and some animal studies that assessed the effects of thyroid hormone administration on stroke, conclusive evidence for clinical application is lacking. This review aimed to determine the consistency of the results between clinical and preclinical studies. This article reviewed the PubMed, Embase, web of Knowledge, and Google Scholar databases up to June 2023 using the MeSH terms “stroke, cerebral ischemia, cerebral infarction, brain ischemia, brain infarction, triiodothyronine (T3), tetraiodothyronine (T4), thyroxine (T4), and thyroid hormone''. The results of clinical and preclinical studies related to T3 substantially confirm each other. That is, in most human studies lower T3 was associated with poor outcomes, and in experimental studies, T3 administration also had therapeutic effects. However, the results of experimental studies related to T4 could not support those of clinical studies. There seem to be some conflicts between experimental and human studies, especially regarding changes and effects of T4 after stroke. The gap between experimental and clinical studies may lead to non-applicable results, wasting time and money, and unnecessary killing of animals

Nursing Students Viewpoints toward Routine Instructional Tools

Introduction: Instructional tools are among effective factors in learning. Learning about students viewpoints towards these tools could help teachers in choosing the most appropriate one. This study was performed to investigate and compare students views towards three routine instructional tools including PowerPoint, overhead, and whiteboard. Methods: In this descriptive study in the year 2007, 68 nursing students in Saveh Nursing School were investigated. The sampling was done by convenient sampling method and data were gathered using a 36 item questionnaire. The reliability and validity of the questionnaire were verified using content validity and internal consistency of data, respectively. Data were analyzed by SPSS software using descriptive (mean, standard deviation, and frequency) and inferential (paired t-test and Pearson correlation coefficient) statistics. Results: The mean scores of positive responses (from 0 to 100) regarding PowerPoint, whiteboard and overhead were 53.65±28.8, 53.65±27.6, and 21.93±25.5, respectively. 57.9% of students preferred PowerPoint, 38.6% chose whiteboard as their most favorable tool, and 3.5% had the preference for overhead. A difference was observed between scores of PowerPoint and overhead (t = 7.26, p < 0.005) as well as scores of whiteboard and overhead (t = 8.16, p < 0.005). Conclusion: Since, there are variations in students preferences for instructional tools, it is recommended that teachers use a combination of different instructional instruments in order to be more effective in promoting students’ motivation and satisfaction in the classroom

Comparison of pre-hospital management of out-of-hospital cardiac arrest and its outcomes between the COVID-19 and pre-COVID-19 periods

Out-of-hospital cardiac arrest (OHCA) is a time-sensitive medical emergency that needs immediate interventions. COVID-19 affected the performance of the emergency medical service (EMS) system in pre-hospital care, including the management of cardiac arrest. This study aimed to identify the impact of the COVID-19 pandemic on pre-hospital management of out-of-hospital cardiac arrest and its outcome in Qom City, Iran. In this descriptive-analytical study, the data were collected from the electronic registration system of the EMS center in Qom, Iran. All OHCA patients who received resuscitation during COVID-19 and before COVID-19 were enrolled in the study. Data consisted of the characteristics of OHCA patients, EMS interventions and response times, and the outcome of OHCA. A P-value of <0.05 was deemed statistically significant. 630 OHCA patients in the COVID-19 period and 524 OHCA patients in the pre-COVID-19 period were included in the study. Endotracheal intubation and defibrillation were done more in the COVID-19 period than in the pre-COVID-19 period (50.2 % vs. 17 %, p<0.001 %, and 40.1 % vs. 22.5 %, p < 0.001, respectively). The EMS response time was longer during the COVID-19 pandemic (9.1 ± 3.9 min vs. 7.6 ± 1.4 min, p < 0.001). The rate of pre-hospital return of spontaneous circulation (ROSC) was lower in the COVID-19 period (15.6 % vs. 8.4 %, p < 0.001). According to univariate analysis, ROSC was predicted by COVID-19 (p < 0.001). However, COVID-19 was not the statistically significant independent predictor after multivariate analysis (p < 0.67). The COVID-19 pandemic period influenced OHCA and ROSC. Also, it affected pre-hospital management in the OHCA situation. The negative impact of COVID-19 on the EMS response reflected the need to know and remove barriers to managing crises such as COVID-19

Bone Marrow Stromal Cells With Exercise and Thyroid Hormone Effect on Post-Stroke Injuries in Middle-aged Mice

Introduction: Based on our previous findings, the treatment of stem cells alone or in combination with thyroid hormone (T3) and mild exercise could effectively reduce the risk of stroke damage in young mice. However, it is unclear whether this treatment is effective in aged or middle-aged mice. Therefore, this study designed to assess whether combination of Bone Marrow Stromal Cells (BMSCs) with T3 and mild treadmill exercise can decrease stroke complications in middle-aged mice.  Methods: Under laser Doppler flowmetry monitoring, transient focal cerebral ischemia was produced by right Middle Cerebral Artery Occlusion (MCAO) for 45 min followed by 7 days of reperfusion in middle-aged mice. BMSCs (1×105) were injected into the right cerebral ventricle 24 h after MCAO, followed by daily injection of triiodothyronine (T3) (20 µg/100 g/d SC) and 6 days of running on a treadmill. Infarct size, neurological function, apoptotic cells and expression levels of Glial Fibrillary Acidic Protein (GFAP) were evaluated 1 week after stroke. Results: Post-ischemic treatment with BMSCs or with T3 and or mild treadmill exercise alone or in combination did not significantly change neurological function, infarct size, and apoptotic cells 7 days after ischemia in middle-aged mice (P>0.05). However, the expression of GFAP significantly reduced after treatment with BMSCs and or T3 (P<0.01).   Conclusion: Our findings indicate that post-stroke treatment BMSCs with exercise and thyroid hormone cannot reverse neuronal damage 7 days after ischemia  in middle-aged mice. These findings further support that age is an important variable in stroke treatmen

Effects of the Oral Ingestion of Probiotics on Brain Damage in a Transient Model of Focal Cerebral Ischemia in Mice

Background: Probiotics are microorganisms that may influence brain function via altering brain neurochemistry. New research evidence suggests that probiotic bacteria might protect tissue damage through diminishing the production of free radicals and/or inflammatory cytokines. Therefore, this study was designed to evaluate the effects of probiotic bacteria on the prevention or reduction of brain damage in an experimental model of stroke in mice. Methods: In this study, 30 male BLC57 mice were randomly divided into 6 equal groups. Focal cerebral ischemia was induced via middle cerebral artery occlusion for 45 minutes, followed by 24 hours of reperfusion, in the mice. Probiotics at a concentration of 107 CFU/mL were administered by oral gavage daily for 14 days before ischemia. Infarct size, neurological outcome, and biochemical markers were measured 24 hours after brain ischemia. Statistical analysis were performed using the one-way ANOVA and/or Kruskal–Wallis ANOVA on rank by Sigma Stat (2.0; Jandel Scientific) software. Results: Our results indicated that pretreatment with probiotics significantly reduced infarct size by 52% (P=0.001) but could not improve neurological function (P=0.26). Moreover, the administration of probiotics significantly decreased the malondialdehyde content (P=0.001) and the tumor necrosis factor-alpha level (P=0.004) in the ischemic brain tissue. Conclusion: The findings of the present study showed that probiotic supplements might be useful in the prevention or attenuation of brain ischemic injury in patients at risk of stroke. Probiotics may open new therapeutic alternatives for the prevention of stroke. More preclinical and clinical studies are, however, needed to clarify their efficacy in cerebral stroke

Critical thinking in nursing education in Iran

Introduction: Nurturing critical thinking is one of the nursing educational goals in Iran. Assessing the critical thinking ability of nurses’ and nursing students' and the effect of current instructional strategies to foster it can assist to determine the efficacy or probable inadequacy of the educational system. The present study reviews the published studies on critical thinking in nursing, in Iran. Methods: This paper reviewed studies concerning critical thinking in nursing, paying particular attention to the effect of academic education on nursing students' critical thinking ability in Iran. This systematic review searched internal resources such as Iranmedex, SID, Magiran and library sources from 2003 through 2009. Other sources such as Pubmed and Elsevier were used for discussion. The key words used were “critical thinking”, “nursing” and “nursing education”. Results: The literature review showed nurses’ and students' critical thinking ability in Iran is low. It also showed that academic education did not have a significant effect on critical thinking. Conclusion: Low critical thinking skills score of nurses and nursing students in literature review asserted that it is necessary to reassess current educational strategies. It is also essential to consider probable insufficiency of critical thinking instruments