Clinical characteristics, management and 1-year outcomes of patients with acute coronary syndrome in Iran: The Iranian Project for Assessment of Coronary Events 2 (IPACE2)

Objectives: To assess contemporary data on characteristics, management and 1-year postdischarge outcomes in Iranian patients hospitalised with acute coronary syndrome (ACS). Setting: 11 tertiary care hospitals in 5 major cities in the Islamic Republic of Iran. Participants: Patients aged �20 and �80 years discharged alive with confirmed diagnosis of ACS including ST-segment elevation myocardial infarction (STEMI), non-STEMI (NSTEMI) and high-risk unstable angina (HR-UA). Primary and secondary outcome measures: Patients were followed up regarding the use of medications and the end points of the study at 1 month and 1 year after discharge. The primary end point of the study was 1-year postdischarge major adverse cardiac and cerebrovascular events (MACCEs), defined as mortality (cardiac and non-cardiac), ACS and cerebrovascular attack (stroke and/or transient ischaemic attack). The secondary end points were hospital admission because of congestive heart failure, revascularisation by coronary artery bypass grafting surgery or percutaneous coronary intervention (PCI), and major and minor bleeds. Results: A total of 1799 patients (25.7 STEMI and 74.3 HR-UA/NSTEMI) discharged alive with confirmed diagnosis of ACS were included in the final analysis. During hospitalisation, the majority of the patients received aspirin (98.6), clopidogrel (91.8), anticoagulants (93.4), statins (94.3) and β-blockers (89.3). Reperfusion therapy was performed in 62.6 of patients with STEMI (46.3 thrombolytic therapy and 17.3 primary PCI). The mean door-to-balloon and door-to-needle times were 82.9 and 45.6 min, respectively. In our study, 64.7 and 79.5 of the patients in HR-UA/NSTEMI and STEMI groups, respectively, underwent coronary angiography. During the 12 months after discharge, MACCEs occurred in 15.0 of all patients. Conclusions: Our study showed that the composition of Iranian patients with ACS regarding the type of ACS is similar to that in developed European countries and is unlike that in developing countries of the Middle East and Africa. We found that our patients with ACS are treated with high levels of adherence to guideline-recommended in-hospital medications

Epidemic assessment of bacterial agents in osteomyelitis and their antibiotic resistance pattern determination

The aim of the present study was to determine the causative agents of osteomyelitis and specifying their antibiotic resistance pattern in patients referred to pediatrics ward of Imam Khomeini Hospital. This study has been performed in Tehran during January to December 2006. In this study, Synovial fluid was taken from 90 patients who referred to pediatrics ward of Imam Khomeini. Samples were examined by direct test, culture and biochemical tests. In next step, antibiogram by disk diffusion method (Kirby-Bauer Test) was established on each positive sample and finally, the results were analyzed. Of 90 examined samples, 27 bacterial cases were isolated; Staphylococcus aureus with 55.9 was the most epidemic agent and Klebsiella sp., coagulase negative Staphylococci, Streptococcus pneumoniae and Enterobacter sp. were the next common agents, respectively. However, it was revealed that more than 40 Staphylococcus aureus are sensitivity to Vacomycin, Gentamicin, Sulfamethoxazole and Erythromycin and most of gram negative Rods isolated of were sensitivity to Amikacin, Ampicillin and Cephalothin (50-100). The most of bacteria (Staphylococcus aureus, coagulase negative Staphylococci, Streptococcus pneumoniae and Enterobacter sp.) were sensitive to Vancomycin, gentamicin and Cephalothin. Similar to previous results, it was proved either in our study that Staphylococcus aureus is the main agent of osteomyelitis and gram negative bacteria with coagulase negative Staphylococci and Streptococci are other agents. Also, it was observed that the most isolated bacteria had high antibiotic resistance to common drugs. © 2008 Asian Network for Scientific Information

Alterations in early auditory evoked potentials and brainstem transmission time associated with tinnitus residual inhibition induced by auditory electrical stimulation

Introduction: Residual inhibition (RI) is the temporary inhibition of tinnitus by use of masking stimuli when the device is turned off. Objective: The main aim of this study was to evaluate the effects of RI induced by auditory electrical stimulation (AES) in the primary auditory pathways using early auditory-evoked potentials (AEPs) in subjective idiopathic tinnitus (SIT) subjects. Materials and Methods: A randomized placebo-controlled study was conducted on forty-four tinnitus subjects. All enrolled subjects based on the responses to AES, were divided into two groups of RI and Non-RI (NRI). The results of the electrocochleography (ECochG), auditory brain stem response (ABR) and brain stem transmission time (BTT) were determined and compared pre- and post-AES in the studied groups. Results: The mean differences in the compound action potential (CAP) amplitudes and III/V and I/V amplitude ratios were significantly different between the RI, NRI and PES controls. BTT was significantly decreased associated with RI. Conclusion: The observed changes in AEP associated with RI suggested some peripheral and central auditory alterations. Synchronized discharges of the auditory nerve fibers and inhibition of the abnormal activity of the cochlear nerve by AES may play important roles associated with RI. Further comprehensive studies are required to determine the mechanisms of RI more precisely

Towards different enterprise architecture project types

This research is in the enterprise architecture (EA) research field. EA is a developing discipline that in broad terms emphasizes all aspects of organizational design and development, including enabling information technology. However, there are various interpretations and understandings of EA, with little agreement on them. Therefore, organizations use EA in numerous ways to achieve different goals. These vary from purely information technology- (IT) related, internal business and IT-related to business environment-related goals. Enterprise architects also have different understandings of EA, which influence the way they perform EA work and consequently EA deliverables and achievement of EA project goals. In this paper a preliminary list of different EA project types is compiled through a hermeneutic literature review, aiming to establish a comprehensive list of EA project types. It is suggested that knowledge of different EA project types assist in the selection of suitable enterprise architects to achieve specific EA project goals.http://www.springer.com/series/7911hj2021Informatic

Diagnostically Challenging Epithelial Odontogenic Tumors: A Selective Review of 7 Jawbone Lesions

Considerable variation in the clinicopathologic presentation of epithelial odontogenic tumors can sometimes be confusing and increase the chance of misdiagnosis. Seven diagnostically challenging jawbone lesions are described. There were 2 cases of mistaken identity in our ameloblastoma file. One unicystic type, initially diagnosed and treated as a lateral periodontal cyst, showed destructive recurrence 6 years postoperatively. The other globulomaxillary lesion was managed under the erroneous diagnosis of adenomatoid odontogenic tumor and recurred 4 times over an 11-year period. This tumor was found in retrospect to be consistent with an adenoid ameloblastoma with dentinoid. The diagnosis of cystic squamous odontogenic tumor (SOT) occurring as a radicular lesion of an impacted lower third molar was one of exclusion. Of two unsuspected keratocystic odontogenic tumors, one depicted deceptive features of pericoronitis, while the other case has long been in our files with the diagnosis of globulomaxillary SOT. Two cases of primary intraosseous squamous cell carcinoma appeared benign clinically and exhibited unexpected findings; an impacted third molar began to erupt in association with the growth of carcinoma and another periradicular carcinoma showed dentinoid formation. Cases selectively reviewed in this article present challenging problems which require clinical and radiographic correlation to avoid potential diagnostic pitfalls

A TaqMan real-time PCR assay for Rhizoctonia cerealis and its use in wheat and soil

Rhizoctonia cerealis causes sharp eyespot in cereals and the pathogen survives as mycelia or sclerotia in soil. Real-time Polymerase Chain Reaction (qPCR) assays based on TaqMan chemistry are highly suitable for use on DNA extracted from soil. We report here the first qPCR assay for R. cerealis using TaqMan primers and a probe based on a unique Sequence Characterised Amplified Region (SCAR). The assay is highly specific and did not amplify DNA from a range of other binucleate Rhizoctonia species or isolates of anastomosis groups of Rhizoctonia solani. The high sensitivity of the assay was demonstrated in soils using a bulk DNA extraction method where 200 μg sclerotia in 50 g of soil were detected. DNA of the pathogen could also be amplified from asymptomatic wheat plants. Using the assay on soil samples from fields under different crop rotations, R. cerealis was most frequently detected in soils where wheat was grown or soil under pasture. It was detected least frequently in fields where potatoes were grown. This study demonstrates that assays derived from SCAR sequences can produce specific and sensitive qPCR assays

Cellular proliferation markers in peripheral and central fibromas: a comparative study

OBJECTIVE: To perform a comparative study of the cellular proliferation in the peripheral and central fibromas. MATERIAL AND METHODS: Immunohistochemistry for PCNA and the AgNOR technique were performed in 9 cases of peripheral odontogenic fibroma (POF), in 4 cases of odontogenic fibroma (OdF), in 8 cases of peripheral ossifying fibroma (PEOF) and 7 cases of ossifying fibroma (OsF). The Kruskal-Wallis and Mann-Whitney tests were used for the statistical analyses. RESULTS: Mesenchymal component of the central lesions presented a higher mean number of AgNOR per nucleus and PCNA index than did the peripheral lesions (P≤0.05). The mean number of AgNOR per nucleus in the epithelial component proved to be higher in the OdF than in the POF (P≤0.05). The mesenchymal and epithelial components presented similar mean numbers of AgNOR per nucleus and PCNA index in the OdF, as well as a similar mean number of AgNOR per nucleus in the POF. CONCLUSIONS: The mesenchymal component may well play a role in the differences between the biological behaviour of the central lesions as compared to the peripheral lesions. Moreover, considering that the epithelial and mesenchymal components in odontogenic fibromas presented a similar proliferation index, more research is warranted to understand the true role of the epithelial components, which are believed to be inactive in nature, as well as in the development and biological behaviour of these lesions

A Bibliometric Analysis of Research on the Convergence of Ar-tificial Intelligence and Blockchain in Smart Cities

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DIAGNOSTIC VALUE OF SILVER-STAINED NUCLEOLAR ORGANIZER REGIONS IN OSTEOSARCOMA, FIBROUS DYSPLASIA AND OSSIFYING FIBROMA OF THE JAWS

It is sometimes difficult to recognize a jaw lesion as osteosarcoma, ossifying fibroma or ‎fibrous dysplasia in routine hematoxylin and ‎eosin staining and a more accurate technique is needed to differentiate these ‎lesions. ‎Many studies have shown the potential usefulness of silver-stained nucleolar organizer region (AgNOR) parameters for the diagnosis of various neoplasms. This study was carried out on 42 archival biopsy specimens of jaw lesions including 14 fibrous dysplasias, 14 ossifying fibromas and 14 ‎osteosarcomas (10 well differentiated and 4 poorly differentiated). Number of AgNORs was evaluated on formalin-fixed, paraffin embedded sections. The mean AgNOR counts showed significant differences between these lesions. The mean counts of AgNORs were 6 for poorly ‎differentiated osteosarcoma. By considering a cutoff point of 1.81-2.5 for well differentiated osteosarcoma and 1-1.8 ‎for ossifying fibroma, well differentiated osteosarcoma can be differentiated from ossifying fibroma with a sensitivity of ‎90% and a specificity of 64.3%. The area under the ROC curve was 0.84. ‎The results in this study indicate that AgNOR staining is a useful technique for differential diagnosis of osteosarcoma, ossifying fibroma and fibrous dysplasia of jaws when it is difficult to recognize these lesions in routine hematoxylin and ‎eosin staining