A comparative study of teaching clinical guideline for prevention of ventilator-associated pneumonia in two ways: face-to-face and workshop training on the knowledge and practice of nurses in the Intensive Care Unit

Introduction: Ventilator-associated pneumonia (VAP) is one of the most popular nosocomial infections in the intensive care units and the nurse’s role in preventing it is very important. The aim of this study was to compare the effect of two methods of face to face training and work- shop clinical guidelines in prevention of VAP. Methods: In this experimental randomized clinical trial, the knowledge and practice of nurses in ICUs were studied in two groups: face to face training (35 nurses) and workshops (40 nurses) by using clinical guidelines in prevention of VAP in one of the hospitals of Shiraz University of Medical Sciences. The level of knowledge and practice in each group was assessed by selfreport questionnaire, knowledge questionnaire and also direct observation of practice, before and after training. Data were analyzed with descriptive statistics, paired t-test, independent t-test, McNemar test, Fisher’s exact, sign and Chi-square test, using SPSS 14. Results: This study demonstrated that both methods of face to face training and workshop were very effective. The incidence of inappropriate pressure of cuff in the tracheal tubes and tracheostomy tubes was significantly reduced after training (p=0.001). But, by comparison of these two methods and the relationship between the variables revealed that no significant difference was found between the two groups of face to face training and workshop. Conclusion: Training the nurses is highly effective in preventing VAP, particularly for appropriate cuff pressure, suctioning and disinfecting hands

Detection of survivin 2α gene expression in thyroid nodules

Context: Functional studies of the survivin splice variants have been performed almost exclusively in various types of cancer and produced remarkable advances in our understanding of cancer biology and cancer genetics. Aim: To observation the expression of survivin 2α in thyroid nodules and estimate its potential as a new molecular marker in thyroid nodules screening and malignant thyroid, as well. Setting and Design: We detected the expression of a splice variant of survivin, survivin 2α, in thyroid nodules. Materials and Methods: Expression of survivin 2α mRNA was evaluated with specific primers by Hemi-Nested RT-PCR in 77 thyroid nodules including malignant and benign tumors, non-tumoral (goiter and thyroiditis) as well as surgical margin, non-neoplastic normal tissues adjacent to the malignant lesions. Result: Our data revealed for the first time the expression of survivin 2α in thyroid nodules. It was detected in 85.7% of non-neoplastic surgical margin tissues, 71.4% of non tumoral, 63.2% of tumoral samples. Also, the expression of survivin 2α in benign tumor samples (64.2%) is more than malignant groups (62.8%). Conclusion: Survivin 2α expression is the highest in non-neoplastic surgical margin rather than other samples and the lowest expression was that of malignancy. According to the results, it can be concluded that survivin 2α protein may be has a vital protective effect throw survivin quenching due to the high expression in normal tissue compared with lesions

Survivin-deltaEx3: A novel biomarker for diagnosis of papillary thyroid carcinoma

Context: The most important problem in the case of thyroid nodules is the lack of suitable criteria for detecting malignant thyroid tumors from other nodules in the early stage. Variable expressions level of survivin, an inhibitory protein in apoptotic pathway, and its splice variants in malignant carcinoma versus well-differentiated normal tissues candidate them as reliable biomarkers in cancers. Aim: To semi-quantitative detection of survivin and its splice variant, survivin-deltaEx3, in thyroid nodules. Setting and Design: We evaluated the expression level of mentioned biomarkers in thyroid nodules including carcinoma. Materials and Methods: Samples were collected from 61 thyroid nodules including malignant, adenoma, non-tumoral (goiter and thyroidities) as well as non-neoplastic normal tissues. Transcriptional levels were measured using semi-quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) and the results were normalized to b2microglubin (b2m) gene. Statistical Analysis Used: Independent sample t-test was used to assess the significant variation of expression between different groups. Result: Our data for a first time revealed that survivin-deltaEx3 is significantly up-regulated from normal to malignant thyroid carcinoma tissues (approximately ten fold). Conclusion: High expression level of survivin and survivin-deltaEx3 in malignant papillary thyroid carcinoma suggested survivin gene expression and its splice variant, survivin-deltaEx3, can be potential new markers in diagnosis of human papillary thyroid carcinoma