Facilitators and barriers of adaptation to diabetes: experiences of Iranian patients

Background: Diabetes mellitus is one of the most challenging and burdensome chronic diseases of the 21st century and More than 1% of the Iranian urban population older than 20 years develops Type 2 diabetes each year. Living with diabetes mellitus has been described as a dynamic personal transitional adaptation, based on restructuring of the illness perceived experience and management of the self. Adaptation to Type 2 Diabetes mellitus is an integral part of diabetes care.This study explored the experiences of facilitators and barriers adaptation to Type 2 Diabetes by Iranian patients.Methods: This study was conducted by using qualitative content analysis. Data were collected via in-depth, semi-structured and face to face interviews with 15 patients with type2 diabetes.Results: Three themes emerged from collected data, including a) individual context with Beliefs, personal background, and previous experience subthemes. b) supportive system with Family, Society and Health organizations subthemes and c) self-comparison with comparison with other diabetes and comparison with other diseases subthemes.Conclusions: Identifying and managing Facilitators and Barriers adaptation to Type 2 Diabetes mellitus are an integral part of diabetes care. This study provides a better understanding of the factors from perspective of patients and it can be utilized by health care providers to adapt their health care and education contents to better meet the needs of people with diabetes. © 2014 Karimi Moonaghi et al.; licensee BioMed Central Ltd

Struggling towards diagnosis: Experiences of Iranian diabetes

Background: Healthcare-seeking behavior is one of the factors determining the uptake and outcome of healthcare. However, few studies have discussed how and why diabetics seek healthcare assistance before meeting a physician. Objectives: In this study, we explored the subjective experiences of healthcare-seeking behavior among Iranian patients with type 2 diabetes mellitus. Patients and Methods: A qualitative approach was adopted using a conventional content analysis of semi-structured interviews carried out in the Diabetes Association in Tabriz (Iran) with 15 participants suffering from type 2 diabetes. Participants were recruited by the purposeful sampling method. Results: Five themes emerged from the study: 1) warning by physical signs; 2) personal processing; 3) self-remedy and its outcomes; 4) seeking information, and; 5) diagnosis and verification of information by healthcare staff. Conclusions: Individual social context plays an important role in the decision-making process when seeking healthcare for diabetes. The results of this study can be utilized by healthcare providers to facilitate interventions to increase diabetics' active involvement in their healthcare, and encourage a wider knowledge of its symptoms and outcomes to facilitate appropriate healthcare-seeking and service use. © 2014, Iranian Red Crescent Medical Journal

Core promoter short tandem repeats as evolutionary switch codes for primate speciation

Alteration in gene expression levels underlies many of the phenotypic differences across species. Because of their highly mutable nature, proximity to the +1 transcription start site (TSS), and the emerging evidence of functional impact on gene expression, core promoter short tandem repeats (STRs) may be considered an ideal source of variation across species. In a genome-scale analysis of the entire Homo sapiens protein-coding genes, we have previously identified core promoters with at least one STR of ≥6-repeats, with possible selective advantage in this species. In the current study, we performed reverse analysis of the entire Homo sapiens orthologous genes in mouse in the Ensembl database, in order to identify conserved STRs that have shrunk as an evolutionary advantage to humans. Two protocols were used to minimize ascertainment bias. Firstly, two species sharing a more recent ancestor with Homo sapiens (i.e. Pan troglodytes and Gorilla gorilla gorilla) were also included in the study. Secondly, four non-primate species encompassing the major orders across Mammals, including Scandentia, Laurasiatheria, Afrotheria, and Xenarthra were analyzed as out-groups. We introduce STR evolutionary events specifically identical in primates (i.e. Homo sapiens, Pan troglodytes, and Gorilla gorilla gorilla) vs. non-primate out-groups. The average frequency of the identically shared STR motifs across those primates ranged between 0.00005 and 0.06. The identified genes are involved in important evolutionary and developmental processes, such as normal craniofacial development (TFAP2B), regulation of cell shape (PALMD), learning and long-term memory (RGS14), nervous system development (GFRA2), embryonic limb morphogenesis (PBX2), and forebrain development (APAF1). We provide evidence of core promoter STRs as evolutionary switch codes for primate speciation, and the first instance of identity-by-descent for those motifs at the interspecies level. © 2014 Wiley Periodicals, Inc

Effects of an Exercise-Oriented Rehabilitation Program on Mechanical Efficiency and Aerobic Capacity in Children with Spastic Cerebral Palsy

AbstractObjectiveChildren suffering from Cerebral Palsy (CP), exhibit movement limitations and physiological abnormalities as compared to normal individuals.The objective of this study was to assess mechanical efficiency and certain cardiovascular indices before and after an exercise-rehabilitation program in children with dipelegia spastic cerebral palsy (experimental group) in comparison with able-bodied children(controls). Material and MethodsIn this study, 15 spastic cerebral palsy (dipelegic) children participated in an exercise-rehabilitation program, three days a week for three months with an average 144bpm of heart rate. The mechanical efficiency (net, gross), rest and submaximal heart rate and maximal oxygen consumption (VO2max) were measured before (pretest) and after (posttest) exercise program on the cycle ergometer according to the Macmaster ergometer protocol. Then control group, of 18 normal children underwent the exercise program and were assessed, following which results of the 2 groups were compared using SPSS for statistical analysis (P<0.05). ResultsMechanical efficiency (net, gross) increased significantly in CP patients after the exercise-rehabilitation program; reults did not alter significantly for the controls.Rest and submaximal heart rate in CP patients decreased significantly after exercise program. Maximal oxygen consumption, which remained unchanged in patients following the exercise program, was similar in patients and controls after the program. ConclusionCerebral palsy patients, because of their high muscle tone, severe degree of spasticity, and involuntary movements are physically more incapacitated and need more energy than normal able-bodied individuals. Rehabilitation and aerobic exercise can be effective in improving their cardiovascular fitness and muscle function and increasing their mechanical efficiency

Theoretical study of dark resonances in micro-metric thin cells

We investigate theoretically dark resonance spectroscopy for a dilute atomic vapor confined in a thin (micro-metric) cell. We identify the physical parameters characterizing the spectra and study their influence. We focus on a Hanle-type situation, with an optical irradiation under normal incidence and resonant with the atomic transition. The dark resonance spectrum is predicted to combine broad wings with a sharp maximum at line-center, that can be singled out when detecting a derivative of the dark resonance spectrum. This narrow signal derivative, shown to broaden only sub-linearly with the cell length, is a signature of the contribution of atoms slow enough to fly between the cell windows in a time as long as the characteristic ground state optical pumping time. We suggest that this dark resonance spectroscopy in micro-metric thin cells could be a suitable tool for probing the effective velocity distribution in the thin cell arising from the atomic desorption processes, and notably to identify the limiting factors affecting desorption under a grazing incidence.Comment: 12 pages, 11 figures theoretical articl

Oral liken planus (OLP)’lu bireylerde kortizol, anksiyete ve depresyon düzeylerinin değerlendirilmesi

Oral liken planus (OLP)’lu bireylerde kortizol, anksiyete ve depresyon düzeylerinin değerlendirilmesi Amaç: Bu çalışmanın amacı; oral liken planus’lu bireylerde kortizol ve anksiyete/ depresyon düzeylerini değerlendirmek ve psikolojik faktörlerin oral liken planus (OLP)’un etyolojisindeki etkilerini saptamaktır. Yöntem: Marmara Üniversitesi Dişhekimliği Fakültesi Oral Diagnoz ve Radyoloji Anabilim Dalı Kliniği’ne başvuran, OLP klinik ön tanısı konmuş 30 birey hasta grubunu, sağlıklı 30 birey ise kontrol grubunu oluşturmuştur. OLP ön tanılı bireylerden kliniğimizde biyopsi materyali alınarak tanı histopatolojik olarak da desteklenmiştir. Hem çalışma hem de kontrol grubunun periferik kan kortizol düzeyleri değerlendirilmiş ve “Spielberger Durumluluk Kaygı Testi (DKT) – Süreklilik Kaygı Testi (SKT)” ile “Zung Depresyon Ölçeği (ZDP)” uygulanmıştır. Bulgular: Çalışma ve kontrol grubundaki hastaların kortizol, DKT ve ZDP değerleri ortalaması arasında anlamlı bir farklılık bulunmazken (p>0.05), çalışma grubunun SKT değerleri ortalaması kontrol grubundan istatistiksel olarak anlamlı düzeyde yüksektir (p<0.05). Sonuç: Oral Liken Planus’lu bireylerde süreklilik kaygı düzeyinin yüksek olması anksiyetenin bu hastalığın etyolojisinde önemli bir faktör olabileceğini ortaya koymaktadı

Regional myocardial ischemia in hypertrophic cardiomyopathy: Impact of myectomy

AbstractObjectiveChest pain is a common finding in patients with hypertrophic cardiomyopathy and can be observed in 40% to 50% of all patients. However, the pathogenesis of these ischemia-like symptoms is still unclear.MethodsTwenty-two patients with hypertrophic cardiomyopathy and 15 controls underwent positron emission tomography for evaluation of regional myocardial perfusion and coronary flow reserve (hyperemic/baseline myocardial blood flow). Myocardial perfusion (mL/min/g) was measured using [13N]ammonia at rest and during hyperemia with dipyridamole (0.56 mg/kg intravenously). Regional coronary flow reserve was assessed in 3 planes (apical, midventricular, basal) in 4 regions (septal, anterior, lateral, inferior). Patients were divided into 2 groups: group 1 consisted of 11 patients treated with surgical myectomy (age 56 ± 10 years) and group 2 consisted of 11 patients treated medically (age 53 ± 13 years).ResultsMean global coronary flow reserve was 3.87 ± 0.92 in controls but 2.31 ± 0.40 in operated (P < .001 vs controls) and 1.76 ± 0.58 in medically treated patients (P < .001 vs controls, P < .05 vs operated). Similarly, septal coronary flow reserve was 4.19 ± 1.22 in controls but significantly reduced in operated patients (2.26 ± 0.48, P < .001 vs controls) and in medically treated patients (1.76 ± 0.58; P < .001 vs controls). However, septal flow reserve was significantly higher in operated patients than in patients with medically treated hypertrophic cardiomyopathy (+37%, P < .05), mainly due to a reduced resting myocardial perfusion.ConclusionsGlobal and regional myocardial perfusion is reduced in patients with hypertrophic cardiomyopathy. However, myectomy may have a beneficial effect on septal perfusion and flow reserve. Thus, ischemia seems to play an important role in the symptomatology and pathophysiology of hypertrophic cardiomyopathy

Left bundle branch block causes relative but not absolute septal underperfusion during exercise

Aims Left bundle branch block (LBBB) often causes septal perfusion defects in radionuclide myocardial perfusion imaging using exercise (Ex) but rarely using vasodilator stress. We studied whether this is due to an underlying structural disease inherent to spontaneous LBBB or whether it is also found in temporary LBBB induced by right ventricular pacing (PM) indicating a functional rather than a structural alteration. Methods and results Regional myocardial blood flow (MBF) at rest and at Ex was measured with(15)O-H(2)O and PET in 10 age-matched healthy volunteers (controls), 10 LBBB patients and 10 PM patients with right ventricular pacing off and on (PM off and PM on). Although at Ex septal MBF tended to be higher in LBBB than in controls (3.04 +/- 1.18 vs. 2.27 +/- 0.72 mL/min/g; P= ns), the ratio septal/lateral MBF was 19% lower in LBBB than in controls (P < 0.05). Similarly, switching PM on at Ex decreased the ratio septal/lateral MBF by 17% (P < 0.005). Conclusion The apparent septal perfusion defect in LBBB is mainly due to a relative lateral hyperperfusion rather than to an absolute septal flow decrease. This pattern seems to be reversibly inducible by right ventricular pacing, suggesting a functional rather than a structural alteratio

Specific Compositions of Cannabis sativa Compounds Have Cytotoxic Activity and Inhibit Motility and Colony Formation of Human Glioblastoma Cells In Vitro

Glioblastoma multiforme (GBM) is the most lethal subtype of glioma. Cannabis sativa is used for the treatment of various medical conditions. Around 150 phytocannabinoids have been identified in C. sativa, among them Δ-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) that trigger GBM cell death. However, the optimal combinations of cannabis molecules for anti-GBM activity are unknown. Chemical composition was determined using high-performance liquid chromatography (HPLC) and gas chromatography mass spectrometry (GC/MS). Cytotoxic activity was determined by XTT and lactate dehydrogenase (LDH) assays and apoptosis and cell cycle by fluorescence-activated cell sorting (FACS). F-actin structures were observed by confocal microscopy, gene expression by quantitative PCR, and cell migration and invasion by scratch and transwell assays, respectively. Fractions of a high-THC cannabis strain extract had significant cytotoxic activity against GBM cell lines and glioma stem cells derived from tumor specimens. A standard mix (SM) of the active fractions F4 and F5 induced apoptosis and expression of endoplasmic reticulum (ER)-stress associated-genes. F4 and F5 inhibited cell migration and invasion, altered cell cytoskeletons, and inhibited colony formation in 2 and 3-dimensional models. Combinations of cannabis compounds exert cytotoxic, anti-proliferative, and anti-migratory effects and should be examined for efficacy on GBM in pre-clinical studies and clinical trials