Validity of Initial Clinical Diagnosis of Unstable Angina Based on the Invasive and Noninvasive Studies

Introduction: A few studies have focused on diagnostic performance of residents for controlling the patients with acute chest pain referring to chest pain units. We aimed to assess diagnostic performance of cardiology residents for controlling the patients with acute chest pain, considering invasive and non-invasive diagnostic modalities as the key standards to confirm or refuse diagnosis of unstable angina.Methods: One hundred and twenty nine patients with chest pain or angina referring to chest pain unit of Modarres hospital between 2013 and 2014 were assessed. The patients were categorized into two subgroups. The first group included 23 patients who were discharged by the resident in initial evaluation because of ruling-out diagnosis of unstable angina, but were assessed non-invasively by exercise test or SPECT as key standards. The second group included 106 patients who were hospitalized and admitted to CCU by residents’ order and also were assessed invasively by coronary angiography or noninvasively by exercise test or SPECT.Results: Overall, of 129 patients, 23 were initially diagnosed not to be necessarily hospitalized and thus were discharged by resident’s order. Of those, assessing by SPECT indicated positive result in five of 19 patients and by exercise test indicated positive result in 1 of 4 patients yielding a sensitivity of 83.3%, a specificity of 17.6%, a PPV of 26.3%, a NPV of 75.0%, and an accuracy of 34.8% for assessing disease by resident. The remaining 106 patients were admitted to CCU ward in accordance with the resident’s order. Among those patients, 85 underwent coronary angiography with positive results in 53 patients. Also, SPECT was positive in 10 of 19 patients and exercise test was positive in one of two patients yielding a sensitivity of 95.3%, a specificity of 0.0%, a PPV of 59.2%, a NPV of 0.0%, and an accuracy of 57.5%.Conclusions: For patients with suspicion to unstable angina, the decision of residents in chest pain units for discharging or admitting patients suspected to unstable angina is accompanied with high sensitivity but unacceptable specificity and thus using supplement diagnostic tools such as exercise test or SPECT can be very helpful for diagnosing unstable angina

9P21.3 locus; An Important Region in Coronary Artery Disease: A Panel Approach to Investigation of the Coronary Artery Disease Etiology

Coronary artery disease (CAD) is a disease of major concern worldwide. It is the main cause of mortality in many societies and improving the understanding about the CAD mechanism, progression and treatment, is necessary. Recent discovery of genetic factors underlying CAD has improved our knowledge of the disease in support of well-known traditional risk factors. Genotype-environment interaction is known as the main risk factor. Loci on many different chromosomes have been identified as a risk factors that increase CAD susceptibility. Here we performed a comprehensive literature review pinpointing hotspot loci involved in CAD pathogenicity. The 9p21.3 locus is the most common region associated with CAD and its specific structure and function have been remarkable in many studies. Moreover, the variations in the 9p21.3 locus have been implicated in CAD patients in different populations around the world. According to conclusions from this the 9p21.3 locus can be the first point of focus in etiology investigations of CAD patients

Evaluation of Microleakage at the Junction Between Combined Amalgam/Composite Resin Restorations Using Different Bonding Systems in Class II Cavities

Objective: To evaluate the microleakage at the junction between amalgam-composite resin restorations using different bonding systems. Material and Methods: In this in-vitro study, standard class II cavities were prepared on 40 human maxillary premolars. The axial and gingival floor depths of the cavities were 2 mm and 1 mm below (cementoenamel junction), respectively. The samples were divided into 4 groups (n = 10). In all groups, a layer of 1-mm thick amalgam was used as a coating for the initial part of the gingival floor. In group 1, no bonding system was used for amalgam restoration. In group 2, G-Premio Bond was applied. G-Premio bond + alloy primer and single bond + alloy primer were used in group 3 and group 4, respectively. The rest of the cavities in all groups were then repaired using FiltekZ250 composite. The samples were thermocycled at 500 rpm and immersed in 1% methylene blue solution for 24 hours to allow dye penetration. Once cut, the samples were placed under a stereomicroscope (40X) to determine the microleakage rate. Data analysis was carried out using post-hoc and Chi-square tests (p<0.05). Results: The highest and lowest microleakage rate was related to groups 1 and 3, respectively. There was a significant difference between groups (1,2) and (1,3), and (1,4), and groups (2,3) (p<0.05). Conclusion: The use of alloy primer and bonding could reduce the microleakage between the two restorations

Rare presentation of COVID-19 in 6-year-old girl: myocarditis with severe restrictive diastolic dysfunction

Since the emergence of COVID-19 in late December 2019, patients were presented at the hospitals with different symptoms, including cardiac manifestations. Recent records of coronavirus infection in children and adolescents have been accompanied by multisystem inflammatory syndrome (MIS-C). Here, we describe a 6 -year-old girl with no history of cardiac disease, infected with COVID-19 and presented at the emergency department with fever and cardiac manifestations. Her echocardiography findings favored myocarditis with restrictive (severe) diastolic dysfunction, a rare manifestation of COVID-19 among children. Unfortunately, despite standard treatment of myocarditis and supportive care, the patient passed away. Therefore, it seems necessary to develop a guideline for the recent cardiac consequences of the pandemic among children and follow their presentations carefully

\u3cem\u3eIn vitro\u3c/em\u3e Effect of Graphene Structures as an Osteoinductive Factor in Bone Tissue Engineering: A Systematic Review

Graphene and its derivatives have been well‐known as influential factors in differentiating stem/progenitor cells toward the osteoblastic lineage. However, there have been many controversies in the literature regarding the parameters effect on bone regeneration, including graphene concentration, size, type, dimension, hydrophilicity, functionalization, and composition. This study attempts to produce a comprehensive review regarding the given parameters and their effects on stimulating cell behaviors such as proliferation, viability, attachment and osteogenic differentiation. In this study, a systematic search of MEDLINE database was conducted for in vitro studies on the use of graphene and its derivatives for bone tissue engineering from January 2000 to February 2018, organized according to the PRISMA statement. According to reviewed articles, different graphene derivative, including graphene, graphene oxide (GO) and reduced graphene oxide (RGO) with mass ratio ≤1.5 wt % for all and concentration up to 50 μg/mL for graphene and GO, and 60 μg/mL for RGO, are considered to be safe for most cell types. However, these concentrations highly depend on the types of cells. It was discovered that graphene with lateral size less than 5 µm, along with GO and RGO with lateral dimension less than 1 µm decrease cell viability. In addition, the three‐dimensional structure of graphene can promote cell‐cell interaction, migration and proliferation. When graphene and its derivatives are incorporated with metals, polymers, and minerals, they frequently show promoted mechanical properties and bioactivity. Last, graphene and its derivatives have been found to increase the surface roughness and porosity, which can highly enhance cell adhesion and differentiation

Graphite/Gold Nanoparticles Electrode for Direct Protein Attachment: Characterization and Gas Sensing Application

In this work, graphite/gold nanoparticles (G/AuNPs) were synthesized through a facile chemical method, and its potential application for direct protein attachment for electrochemical detection of carbon monoxide (CO) was investigated. The preparation of G/AuNPs electrodes was optimized by synthesizing the nanoparticles in different concentration of HAuCl4.3H2O at various temperatures. The G/AuNPs electrode was subsequently modified by four types of mercaptopropionic acid, including 1-mercaptopropionic, 3-mercaptopropionic, 6-mercaptopropionic, and 11-mercaptopropionic acid, to achieve the best structure for protein attachment. Visible absorption and electrochemical studies showed that 3-mercaptopropionic acid possesses the best performance regarding the electrical conductivity between electrode and protein redox center. The cyclic voltammetry results revealed that the modified electrode has an appropriate performance for CO detection at very low concentrations while keeping a linear response. The limit of detection for the modified electrode was calculated to be about 0.2 ppb. Finally, the interactions of cytochrome C and carbon monoxides were simulated using molecular dynamics (MD), and the effect of protein conformation changes on the electrochemical signal was thoroughly examined. The simulation results suggested that the proposed electrochemical sensor has an acceptable performance for the detection of CO due to less fluctuation of amino acids near the protein chain in the presence of CO molecules

The Involvement of Mir-210 in Unrestricted Somatic Stem Cells Differentiation into Osteoblasts

Introduction: Bone surgery as a current bone treatment method is not always successful to fulfil bone repair in bone degenerative diseases orextensive injuries. Due to the limited capacity of bone remodeling, the demand for alternative approaches remains to be met. Thus, efforts in exvivo generation of bone forming cells, osteoblasts, and their further application in cell therapy as a promising approach are of vital prominencefrom a scientific perspective. Though several studies have focused on microRNA roles in osteoblast differentiation in various cell recourses, yetnone has reported miR-210 enhancing role in human mesynchymal stem cells (MSCs) so far.Materials and Methods: Hence, we wished toexamine the nature of the relationship between osteoblast differentiation and miR-210 in unique human mesynchymal stem cells, unrestrictedsomatic stem cells (USSCs). Osteoblast markers at gene level namely, Runx2, col I in addition to osteocalcin were assessed using qRT-PCR, andAlizarin Red S staining was also carried out to observe histochemical changes 7 days following miR-210 transduction.Results: The conclusion that follows from our findings represents a marked increase in osteoblast differentiation markers. Interestingly, for the first time, human USSCsdifferentiation into osteoblasts was performed in our research.Conclusion: our study may provide helpful insights into surmounting bonerelated issues by combination of both gene and cell therapy

A Glassy Carbon Electrode Modified with Reduced Graphene Oxide and Gold Nanoparticles for Electrochemical Aptasensing Of Lipopolysaccharides from Escherichia Coli Bacteria

An electrochemical aptasensor is described for the voltammetric determination of lipopolysaccharide (LPS) from Escherichia coli 055:B5. Aptamer chains were immobilized on the surface of a glassy carbon electrode (GCE) via reduced graphene oxide and gold nanoparticles (RGO/AuNPs). Fast Fourier transform infrared, X-ray diffraction and transmission electron microscopy were used to characterize the nanomaterials. Cyclic voltammetry, square wave voltammetry and electrochemical impedance spectroscopy were used to characterize the modified GCE. The results show that the modified electrode has a good selectivity for LPS over other biomolecules. The hexacyanoferrate redox system, typically operated at around 0.3 V (vs. Ag/AgCl) is used as an electrochemical probe. The detection limit is 30 fg·mL−1. To decrease the electrochemical potential for detection of LPS, Mg/ carbon quantum dots were used as redox active media. They decrease the detection potentialto 0 V and the detection of limit (LOD) to 1 fg·mL−1. The electrode was successfully used to analyze serum of patients and healthy persons

The exact synchronization timing between the cleavage embryo stage and duration of progesterone therapy-improved pregnancy rates in frozen embryo transfer cycles: A cross-sectional study

Background: Synchronization between the embryonic stage and the uterine endometrial lining is important in the outcomes of the vitrified-warmed embryo transfer (ET) cycles. Objective: The aim was to investigate the effect of the exact synchronization between the cleavage stage of embryos and the duration of progesterone administration on the improvement of clinical outcomes in frozen embryo transfer (FET) cycles. Materials and Methods: 312 FET cycles were categorized into two groups: (A) day- 3 ET after three days of progesterone administration (n = 177) and (B) day-2 or -4 ET after three days of progesterone administration (n = 135). Group B was further divided into two subgroups: B1: day-2 ET cycles, that the stage of embryos were less than the administrated progesterone and B2: day-4 ET cycles, that the stage of embryos were more than the administrated progesterone. The clinical outcome measures were compared between the groups. Results: The pregnancy outcomes between groups A and B showed a significant differences in the chemical (40.1% vs 27.4%; p = 0.010) and clinical pregnancies (32.8% vs 22.2%; p = 0.040), respectively. The rate of miscarriage tended to be higher and live birth rate tended to be lower in group B than in group A. Also, significantly higher rates were noted in chemical pregnancy, clinical pregnancy, and live birth in group A when compared with subgroup B2. Conclusion: Higher rates of pregnancy and live birth were achieved in day-3 ET after three days of progesterone administration in FET cycles. Key words: Endometrium, Embryo transfer, Pregnancy, Live birth, Progesterone