Endoscopic correction of vesicoureteral reflux in children

Introduction: Dextranomer/hyaluronic (Dx/HA) acid is the only tissue-augmenting agent approved by the Food and Drug Administration (FDA) for the vesicoureteral reflux (VUR) treatment. Objectives: We aimed to evaluate short-term outcomes of the Dx/HA in patients who had undergone subureteric injection. Patients and Methods: In this study, 30 patients with VUR diagnosis who had indications for open surgery were enrolled in the study. Patients underwent subureteric Dx/HA injection. Additionally patients underwent a one-year follow up period, subsequently. Follow up included urine analysis, urine cultures and kidney and urinary tract ultrasonography study. Results: Of a total 30 patients, 8 patients (27) were male and 22 patients (73) were female. The mean age of patients was 25.19 ± 0.70 months. Postoperative VUR resolution was observed in 28 patients (93.3). Moreover, during one year follow up, urinary tract infection (UTI) was not reported in patients. However, recurrent VUR was detected in 8 patients (27) during ultrasonography follow up. Analysis showed no significant difference of recurrence in VUR between males and females (P = 0.285) and VUR severity (P = 0.1). There was a significant relationship between recurrent UTI history before intervention and VUR recurrence after subureteric injection (P = 0.007). Conclusion: Dx/HA acid subureteric injection provides acceptable resolution rate among VUR patients, but its biodegradability causes VUR recurrence during one-year follow up. © 2018 The Author(s)

Endoscopic correction of vesicoureteral reflux in children

Introduction: Dextranomer/hyaluronic (Dx/HA) acid is the only tissue-augmenting agent approved by the Food and Drug Administration (FDA) for the vesicoureteral reflux (VUR) treatment. Objectives: We aimed to evaluate short-term outcomes of the Dx/HA in patients who had undergone subureteric injection. Patients and Methods: In this study, 30 patients with VUR diagnosis who had indications for open surgery were enrolled in the study. Patients underwent subureteric Dx/HA injection. Additionally patients underwent a one-year follow up period, subsequently. Follow up included urine analysis, urine cultures and kidney and urinary tract ultrasonography study. Results: Of a total 30 patients, 8 patients (27) were male and 22 patients (73) were female. The mean age of patients was 25.19 ± 0.70 months. Postoperative VUR resolution was observed in 28 patients (93.3). Moreover, during one year follow up, urinary tract infection (UTI) was not reported in patients. However, recurrent VUR was detected in 8 patients (27) during ultrasonography follow up. Analysis showed no significant difference of recurrence in VUR between males and females (P = 0.285) and VUR severity (P = 0.1). There was a significant relationship between recurrent UTI history before intervention and VUR recurrence after subureteric injection (P = 0.007). Conclusion: Dx/HA acid subureteric injection provides acceptable resolution rate among VUR patients, but its biodegradability causes VUR recurrence during one-year follow up. © 2018 The Author(s)

Nurses' Experiences Of Adherence To Basic Hygiene Routines In Relation To Healthcare-Associated Infections In Inpatient Care : A literature review

Bakgrund: Vårdrelaterade infektioner är den vanligaste vårdskadan som har konsekvenser för både enskilda patienter och samhället. Konsekvenser för patienter är bland annat lidande och längre sjukhusvistelser vilket innebär höga kostnader för sjukvården i samhället. Vårdrelaterade infektioner kan förebyggas genom följsamhet av basala hygienrutiner. Dessa förebyggande åtgärder missas ofta av sjuksköterskor. Att förstå faktorerna som påverkar vårdpersonalens följsamhet av basala hygienrutiner är nyckeln till att förbättra implementeringen av hygienrutiner. Syfte: Syftet med denna litteraturstudie är att beskriva sjuksköterskors upplevelser av följsamhet till basala hygienrutiner i förhållande till vårdrelaterade infektioner i slutenvård. Metod: I denna litteraturstudie inhämtades information utifrån tolv vetenskapliga studier med kvalitativa ansatser. Studierna inhämtades ur två databaser, Cinahl och PubMed. Studierna analyserades induktivt med innehållsanalys som metod. Resultat: Tre huvudkategorier och sju underkategorier identifierades och tematiserades. Huvudkategorierna var följande: akut situation, individuella hinder och organisatoriska hinder. Kategorierna delades sedan in i sju underkategorier: kunskap och färdigheter, emotionella attityder, resursbrister, tillgänglighet av utrustning, utrustnings kvalitet, kulturella beteende och ledarskap. Slutsats: Inom hälso- och sjukvården finns risk för yrkesmässig exponering, vilket innebär att personalen kan komma i kontakt med smittsamma sjukdomar. För att minimera dessa risker och säkerställa en trygg arbetsmiljö behövs ytterligare forskning om hur systemiska faktorer som påverkar infektionsförebyggande åtgärder som missas. Denna kunskap kommer att underlätta genomförandet av förebyggande åtgärder som bidrar till att undvika yrkesmässig exponering.Nyckelord: Basala hygienrutiner, Följsamhet, Nosokomial infektionsprevention, Sjuksköterskans upplevelse, Vårdrelaterad infektion

Nurses' Experiences Of Adherence To Basic Hygiene Routines In Relation To Healthcare-Associated Infections In Inpatient Care : A literature review

Bakgrund: Vårdrelaterade infektioner är den vanligaste vårdskadan som har konsekvenser för både enskilda patienter och samhället. Konsekvenser för patienter är bland annat lidande och längre sjukhusvistelser vilket innebär höga kostnader för sjukvården i samhället. Vårdrelaterade infektioner kan förebyggas genom följsamhet av basala hygienrutiner. Dessa förebyggande åtgärder missas ofta av sjuksköterskor. Att förstå faktorerna som påverkar vårdpersonalens följsamhet av basala hygienrutiner är nyckeln till att förbättra implementeringen av hygienrutiner. Syfte: Syftet med denna litteraturstudie är att beskriva sjuksköterskors upplevelser av följsamhet till basala hygienrutiner i förhållande till vårdrelaterade infektioner i slutenvård. Metod: I denna litteraturstudie inhämtades information utifrån tolv vetenskapliga studier med kvalitativa ansatser. Studierna inhämtades ur två databaser, Cinahl och PubMed. Studierna analyserades induktivt med innehållsanalys som metod. Resultat: Tre huvudkategorier och sju underkategorier identifierades och tematiserades. Huvudkategorierna var följande: akut situation, individuella hinder och organisatoriska hinder. Kategorierna delades sedan in i sju underkategorier: kunskap och färdigheter, emotionella attityder, resursbrister, tillgänglighet av utrustning, utrustnings kvalitet, kulturella beteende och ledarskap. Slutsats: Inom hälso- och sjukvården finns risk för yrkesmässig exponering, vilket innebär att personalen kan komma i kontakt med smittsamma sjukdomar. För att minimera dessa risker och säkerställa en trygg arbetsmiljö behövs ytterligare forskning om hur systemiska faktorer som påverkar infektionsförebyggande åtgärder som missas. Denna kunskap kommer att underlätta genomförandet av förebyggande åtgärder som bidrar till att undvika yrkesmässig exponering.Nyckelord: Basala hygienrutiner, Följsamhet, Nosokomial infektionsprevention, Sjuksköterskans upplevelse, Vårdrelaterad infektion

Cerebrolysin effects on neurological outcomes and cerebral blood flow in acute ischemic stroke

Mohammad Reza Amiri-Nikpour,1 Surena Nazarbaghi,1 Babak Ahmadi-Salmasi,1 Tayebeh Mokari,2 Urya Tahamtan,2 Yousef Rezaei3 1Department of Neurology, Imam Khomeini Hospital, 2School of Medicine, 3Seyyed-al-Shohada Heart Center, Urmia University of Medical Sciences, Urmia, Iran Background: Cerebrolysin, a brain-derived neuropeptide, has been shown to improve the neurological outcomes of stroke, but no study has demonstrated its effect on cerebral blood flow. This study aimed to determine the cerebrolysin impact on the neurological outcomes and cerebral blood flow. Methods: In a randomized, double-blinded, placebo-controlled trial, 46 patients who had acute focal ischemic stroke were randomly assigned into two groups to receive intravenously either 30 mL of cerebrolysin diluted in normal saline daily for 10 days (n=23) or normal saline alone (n=23) adjunct to 100 mg of aspirin daily. All patients were examined using the National Institutes of Health Stroke Scale and transcranial Doppler to measure the mean flow velocity and pulsatility index (PI) of their cerebral arteries at baseline as well as on days 30, 60, and 90. Results: The patients’ mean age was 60±9.7 years, and 51.2% of patients were male. The National Institutes of Health Stroke Scale was significantly lower in the cerebrolysin group compared with the placebo group on day 60 (median 10, interquartile range 9–11, P=0.008) and day 90 (median 11, interquartile range 10–13.5, P=0.001). The median of PI in the right middle cerebral artery was significantly lower in the cerebrolysin group compared with the placebo group on days 30, 60, and 90 (P<0.05). One patient in the cerebrolysin group and two patients in the placebo group died before day 30 (4.3% versus 8.7%). Conclusion: Cerebrolysin can be useful to improve the neurological outcomes and the PI of middle cerebral artery in patients with acute focal ischemic stroke. Keywords: ischemic stroke, cerebrolysin, neuroprotection, NIHSS, mean flow velocity, pulsatility inde

Wound healing in Behcet's syndrome

Background Because there is an increased inflammatory response to trauma, particularly of the skin, in patients with Behcet's syndrome (BS), an alteration in wound healing in BS is expected. The aim of this study was to investigate the healing features of punch biopsy wounds in BS and acne vulgaris (AV) patients used as controls

Efficient syntheses of benzothiazepines as antagonists for the mitochondrial sodium-calcium exchanger: Potential therapeutics for type II diabetes

Type II diabetes mellitus is a chronic metabolic disorder that can lead to serious cardiovascular, renal, neurologic, and retinal complications. While several drugs are currently prescribed to treat type II diabetes, their efficacy is limited by mechanism-related side effects (weight gain, hypoglycemia, gastrointestinal distress), inadequate efficacy for use as monotherapy, and the development of tolerance to the agents. Consequently, combination therapies are frequently employed to effectively regulate blood glucose levels. We have focused on the mitochondrial sodium-calcium exchanger (mNCE) as a novel target for diabetes drug discovery. We have proposed that inhibition of the mNCE can be used to regulate calcium flux across the mitochondrial membrane, thereby enhancing mitochondrial oxidative metabolism, which in turn enhances glucose-stimulated insulin secretion (GSIS) in the pancreatic beta-cell. In this paper, we report the facile synthesis of benzothiazepines and derivatives by S-alkylation using 2-aminobenzhydrols. The syntheses of other bicyclic analogues based on benzothiazepine, benzothiazecine, benzodiazecine, and benzodiazepine templates are also described. These compounds have been evaluated for their inhibition of mNCE activity, and the results from the structure-activity relationship (SAR) studies are discussed

Efficient syntheses of benzothiazepines as antagonists for the mitochondrial sodium-calcium exchanger: potential therapeutics for type II diabetes

Type II diabetes mellitus is a chronic metabolic disorder that can lead to serious cardiovascular, renal, neurologic, and retinal complications. While several drugs are currently prescribed to treat type II diabetes, their efficacy is limited by mechanism-related side effects (weight gain, hypoglycemia, gastrointestinal distress), inadequate efficacy for use as monotherapy, and the development of tolerance to the agents. Consequently, combination therapies are frequently employed to effectively regulate blood glucose levels. We have focused on the mitochondrial sodium-calcium exchanger (mNCE) as a novel target for diabetes drug discovery. We have proposed that inhibition of the mNCE can be used to regulate calcium flux across the mitochondrial membrane, thereby enhancing mitochondrial oxidative metabolism, which in turn enhances glucose-stimulated insulin secretion (GSIS) in the pancreatic β-cell. In this paper, we report the facile synthesis of benzothiazepines and derivatives by S-alkylation using 2-aminobenzhydrols. The syntheses of other bicyclic analogues based on benzothiazepine, benzothiazecine, benzodiazecine, and benzodiazepine templates are also described. These compounds have been evaluated for their inhibition of mNCE activity, and the results from the structure-activity relationship (SAR) studies are discussed