Lymphomas in Golestan province of Iran: Results of a population-based cancer registry

Introduction: Malignancies of lymphoid cells can be divided into Hodgkin and non-Hodgkin lymphomas (NHL) on the basis of pathologic features, clinical manifestations and treatment. In this paper we present data on lymphomas in Golestan province, in the northeast of Iran, during 2004-2006, using three years results of the Golestan population-based cancer registry (GPCR), a voting member of the International Association of Cancer Registries (IACR). Methods: GPCR started collecting data on all cancers from all public and private diagnostic and therapeutic centers (hospitals, specialist physicians' offices, pathology, laboratory, and imaging centers) of Golestan province in 2004. Here, we used the Iranian national census data to identify the population characteristics of this geographical area. The last census was done in 2006 and the next one will be done in 2011. The population data for years between the national census intervals are retrieved from provincial census done annually by health deputy of Golestan University of Medical Sciences (GOUMS). Results: A total of 5,076 cancer cases were diagnosed in the GPCR between 2004 and 2006. Of these, 237 (4.67 %) were lymphomas, among the ten top cancers of this area, the patients having a mean (±SD) age of 45.2 (±20.9) years. The number of cases, frequency, age specific rates, crude rates and age standardized incidence rates (ASR) (per 100,000 personyears) for lymphomas in males and females are presented. Conclusion: It could be concluded that according to available therapies for HL and NHL, the outcome of the patients could be improved in this area, due to the better diagnostic and therapeutic methods now available

Non-Hausdorff Symmetries of C*-algebras

Symmetry groups or groupoids of C*-algebras associated to non-Hausdorff spaces are often non-Hausdorff as well. We describe such symmetries using crossed modules of groupoids. We define actions of crossed modules on C*-algebras and crossed products for such actions, and justify these definitions with some basic general results and examples.Comment: very minor changes. To appear in Math. An

Cardiac Hydatid cyst without liver involvement: A case report

Hydatid disease is a rare parasitic disease, which mainly involves liver then lung tissues. Cardiac involvement is very rare, especially when there is not hepatic in-volvement. We describe a 47-year-old woman with a history of a lung hydatid cyst who was referred to Rajaei Heart Center, Tehran, Iran in 2012. Her chest computed tomographic scan showed a cardiac mass. Echocardiographic exami-nation illustrated a large, well-defined heterogeneous mass (4.5 � 2.5 cm) in the roof of the right atrium with attachment to the crista terminalis without com-pressive effect on the inferior and superior venae cavae. The patient was candi-date for open-heart surgery via median sternotomy. A cystic mass was observed in the lateral aspect of the right atrial wall. After an injection of hypertonic nor-mal saline into the cystic lesion, the mass was excised totally. The right atrial de-fect was reconstructed with autologous pericardium. The patient was discharged from the hospital in good condition. Histological examination confirmed the di-agnosis of the hydatid cyst. © 2016, Tehran University of Medical Sciences (TUMS). All rights reserved

Functional Imaging of Human Vestibular Cortex Activity Elicited by Skull Tap and Auditory Tone Burst

The current study characterizes brain activation in response to two modes of vestibular stimulation: skull tap and auditory tone burst. The auditory tone burst has been used in previous studies to elicit either the vestibulo-spinal reflex (saccular-mediated colic Vestibular Evoked Myogenic Potentials (cVEMP)), or the ocular muscle response (utricle-mediated ocular VEMP (oVEMP)). Some researchers have reported that air-conducted skull tap elicits both saccular and utricle-mediated VEMPs, while being faster and less irritating for the subjects. However, it is not clear whether the skull tap and auditory tone burst elicit the same pattern of cortical activity. Both forms of stimulation target the otolith response, which provides a measurement of vestibular function independent from semicircular canals. This is of high importance for studying otolith-specific deficits, including gait and balance problems that astronauts experience upon returning to earth. Previous imaging studies have documented activity in the anterior and posterior insula, superior temporal gyrus, inferior parietal lobule, inferior frontal gyrus, and the anterior cingulate cortex in response to different modes of vestibular stimulation. Here we hypothesized that skull taps elicit similar patterns of cortical activity as the auditory tone bursts, and previous vestibular imaging studies. Subjects wore bilateral MR compatible skull tappers and headphones inside the 3T GE scanner, while lying in the supine position, with eyes closed. Subjects received both forms of the stimulation in a counterbalanced fashion. Pneumatically powered skull tappers were placed bilaterally on the cheekbones. The vibration of the cheekbone was transmitted to the vestibular system, resulting in the vestibular cortical response. Auditory tone bursts were also delivered for comparison. To validate our stimulation method, we measured the ocular VEMP outside of the scanner. This measurement showed that both skull tap and auditory tone burst elicited vestibular evoked myogenic potentials, indicated by eye muscle responses. We further assessed subjects' postural control and its correlation with vestibular cortical activity. Our results provide the first evidence of using skull taps to elicit vestibular activity inside the MRI scanner. By conducting conjunction analyses we showed that skull taps elicit the same activation pattern as auditory tone bursts (superior temporal gyrus), and both modes of stimulation activate previously identified vestibular cortical regions. Additionally, we found that skull taps elicit more robust vestibular activity compared to auditory tone bursts, with less reported aversive effects. This further supports that the skull tap could replace auditory tone burst stimulation in clinical interventions and basic science research. Moreover, we observed that greater vestibular activation is associated with better balance control. We showed that not only the quality of balance (indicated by the amount of body sway) but also the ability to maintain balance for a longer time (indicated by the balance time) was associated with individuals' vestibular cortical excitability. Our findings support an association between vestibular cortical activity and individual differences in balance. In sum, we found that the skull tap stimulation results in activation of canonical vestibular cortex, suggesting an equally valid, but more tolerable stimulation method compared to auditory tone bursts. This is of high importance in longitudinal vestibular assessments, in which minimizing aversive effects may contribute to higher protocol adherence

Analysis of implications of organ donation on living donors in southeastern Iran: A qualitative study

Objectives: despite the annual increase in living donors and the positive and negative implications following organ donation, this issue had become a significant challenge for donors. The present study aimed to analyze the experiences and views of living donors to organ donation implications.Material and Methods. The present study was performed using qualitative content analysis. Twenty participants were selected using the purposive sampling method; data were collected by semi-structured interviews and analyzed based on Lundman and Graneheim contractual content analysis method after implementing MAX 12.Results. Data analysis elicitated 721 codes, 20 subcategories, six main categories, and two themes, including positive and negative implications of organ donation from the viewpoint of living donors. The main categories of positive effects resulting from organ donation included the «donor’s peace of mind», «fundamental strength», and «recipient’s achievements». On the other hand, the main categories of negative implications resulting from organ donation included «donor’s physical suffering», «damaged interactions», and «abandonment».Conclusion. Increasing the number of living donors makes us consider it essential to understand the efficiency of its two-way implications on many aspects of donor and recipient. Thus, managing the negative impacts of living organ donation and strengthening its positive side emphasizes the need to increase the awareness of organ donation associations, develop health policies at higher levels, and, most importantly, improve the satisfaction of live organ donors

In-hospital and six-month outcomes of elderly patients undergoing primary percutaneous coronary intervention for acute st-elevation myocardial infarction

BACKGROUND: Elderly patients constitute a rapidly growing proportion of the population, and hence the increasing rises in the number of patients with ST-segment-elevation myocardial infarction (STEMI). Primary percutaneous coronary intervention (PCI), which is now established as the preferred reperfusion strategy in STEMI patients, has been inadequately investigated in this high-risk group. The aim of the present study was to investigate the in- hospital and 6-month outcomes of primary PCI in elderly patients (� 75 years) with STEMI. METHODS: A total of 100 elderly patients with STEMI including those with cardiogenic shock were included. Primary PCI procedures were performed in a tertiary referral center between 2009 and 2014. In-hospital and 6-month outcomes of patients were recorded and analyzed. RESULTS: The average age of the patients was 79.6 ± 3.8 years (range = 75-90 years) and 27.0 were women. Cardiovascular risk factors and prior events were common. Nearly, half of the patients had three-vessel disease and the left anterior descending artery (LAD) was the most common infarct-related artery. The presence of cardiogenic shock but not the other variables was associated with less anatomic and procedural success (P < 0.001). It was also the major independent predictors of 6-month mortality in the patients aged � 75 years, hazard ratio (HR) = 8.02; 95% confidence interval (CI): 1.75-25.97, P < 0.001. In-hospital mortality was 2.4% in the patients without and 83.0% in those with cardiogenic shock. CONCLUSION: Primary PCI in aged patients could be associated with low complication rates and improved survival if performed in high-volume centers with experienced operators. Considering the very high rate of mortality in patients with cardiogenic shock, there should be measures to treat these patients before the onset of hemodynamic instability. © 2016, Isfahan University of Medical Sciences(IUMS). All rights reserved

Suprasternal innominate artery cannulation for reoperative aortic surgery: A technical note

Suprasternal cannulation of the innominate artery in aortic reoperations may be useful in specific situations. Over a period of 3.5 years, 9 patients (6 males, average age = 49.2 ± 16.1 years) underwent suprasternal cannulation prior to resternotomy. Cannulation was performed using a side graft. All operations were successfully completed. Two patients died after surgery because of coagulopathy and multiorgan failure. There were no complications related to access or technique, and no site complications were detected during follow-up. Suprasternal cannulation of the innominate artery may play a role in selected reoperations. © 2016 The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved

Relationship between maximum clot firmness in ROTEM® and postoperative bleeding after coronary artery bypass graft surgery in patients using clopidogrel

Background: The aim of the present study was to investigate the relationship between maximum clot firmness (MCF) in rotational thromboelastometry (ROTEM®) and postoperative bleeding in patients on clopidogrel after emergency coronary artery bypass graft surgery (CABG). Methods: This observational study recruited 60 patients posted for emergency CABG following unsuccessful primary percutaneous coronary intervention (PCI) while on 600 mg of clopidogrel. The study population was divided into 2 groups on the basis of their MCF in the extrinsically activated thromboelastometric (EXTEM) component of the (preoperative) ROTEM® test: patients with MCF &lt;50 mm (n = 16) and those with MCF �50 mm (n = 44). Postoperative chest tube drainage amount, need for blood product transfusion, postoperative complications, and duration of mechanical ventilation after CABG were recorded. Results: No significant differences were observed between the two groups regarding duration of surgery, cardiopulmonary bypass, and aortic cross-clamp time. Chest tube drainage at 6, 12, and 24 h after Intensive Care Unit admission were significantly higher in the patients with MCF below 50 mm. The need for blood product transfusion was higher in the group with MCF &lt;50 mm. In patients who experienced postoperative bleeding of 1000 mL or more, the ROTEM® parameters of INTEM (Intrinsically activated thromboelastomery) and MCF, EXTEM and MCF, and HEPTEM (INTEM assay performed in the presence of heparinase) MCF (but not FIBTEM (Thromboelastometric assay for the fibrin part of the clot) values) were significantly lower than those with postoperative bleeding &lt;1000 mL (P � 0.05). Conclusions: When platelet aggregometry is not available, the ROTEM® test could be useful for the prediction of increased risk bleeding after emergency CABG in patients who have received a loading dose of clopidogrel. © 2018 Annals of Cardiac Anaesthesia | Published by Wolters Kluwer - Medknow

Are serial hematocrit measurements sensitive enough to predict intra-abdominal injuries in blunt abdominal trama?

Objective: Routine serial hematocrit measurements are a component of the trauma evaluation for patients without serious injury identified on initial evaluation. We sought to determine whether serial hematocrit testing was useful in predicting the probable injuries in blunt abdominal trauma. Materials and method: We performed a prospective study of trauma patients admitted in our observation unit over a 12-month period. Patients routinely underwent serial hematocrit testing in 6-hour intervals (two hematocrit levels). We compared trauma patients with a hematocrit drop of 5 and 10 points or more to those without a significant hematocrit drop. Results: Five hundred forty-two isolated blunt abdominal trauma patients were admitted to observation unit, and 468 patients (86.35) had serial hematocrit during their 6-hour stay. Of these patients, 36.11 had a hematocrit drop of 5 or more and 12.61 a drop of 10 or more. Of patients with the hematocrit drop >10, 50.8 have had diagnostic manifestations of intra-abdominal injury in both ultrasonographic and computed tomography scanning (P5 and positive imaging. Conclusion: Although serial hematocrit testing may be useful in specific situations, routine use of serial hematocrit testing in trauma patients at a level I trauma center�s observation unit did not significantly aid in the prediction of occult injuries. © 2019 Mosaddegh et al

Complete intersections: Moduli, Torelli, and good reduction

We study the arithmetic of complete intersections in projective space over number fields. Our main results include arithmetic Torelli theorems and versions of the Shafarevich conjecture, as proved for curves and abelian varieties by Faltings. For example, we prove an analogue of the Shafarevich conjecture for cubic and quartic threefolds and intersections of two quadrics.Comment: 37 pages. Typo's fixed. Expanded Section 2.