Health-related quality of life and medication adherence in elderly patients with epilepsy

© 2019 Polish Neurological Society. Objective. Considering the high prevalence of epilepsy in the elderly and the importance of maximising their quality of life (QoL), this study aimed to investigate the relationship between medication adherence and QoL, and the mediating effects of medication adherence on the association between serum antiepileptic drug (AED) level and seizure severity with QoL in elderly epileptics. Methods. In a longitudinal study, 766 elderly patients with epilepsy who were prescribed a minimum of one antiepileptic drug were selected by convenience sampling method. A Medication Adherence Report Scale (MARS-5) questionnaire was completed at the baseline. Seizure severity and QoL were assessed after six months using the Liverpool Seizure Severity Scale (LSSS) and the QoL in Epilepsy (QOLIE-31) questionnaires respectively. Serum level of AED was also measured at six-month follow-up. Results. Medication adherence was significantly correlated with both seizure severity (β = -0.33, p < 0.0001) and serum AED level (β = 0.29, p < 0.0001) after adjusting for demographic and clinical characteristics. Neither QoL nor its sub-classes were correlated with seizure severity. In addition, a significant correlation was not observed between serum AED level and QoL. However, medication adherence was significantly correlated with QoL (β = 0.30, p < 0.0001). The mediating effects of medication adherence on the association between serum AED level (Z = 3.39, p < 0.001) and seizure severity (Z = -3.47, p < 0.001) with QoL were supported by the Sobel test. Conclusion. This study demonstrates that medication adherence has a beneficial impact on QoL in elderly epileptics. Therefore, adherence to treatment should be monitored to improve their QoL

Development of Indirect Immunofluorescence Technique for the Identification of MRC5 Working Seed Cell

Diploid and continuous cell lines are used to propagate viral vaccines. At Human Viral Vaccine Department of Razi Vaccine and Serum Research Institute, MRC5 diploid cell is used for the development of live attenuated measles, mumps, rubella, and three types of poliovirus vaccines.  Additionally, three continuous cell lines (i.e., RK13, HeLa, and Vero) are applied in quality control tests. Accordingly, cell cross-contamination can occur at cell culture labs, hence controlling the identity and specificity of cells is essential. Indirect immunofluorescence is a sensitive, specific, and simple test for cell identification. The present study was designed to develop the in-house indirect immunofluorescence test (IIF) as follows: homemade polyclonal anti-MRC5 serum was prepared in rabbits, and cross-reactive antibodies to RK13, HeLa, and Vero cells were eliminated. The diploid and continuous cell lines were fixed on Teflon slide using cold methanol and acetone. The reproducibility of the in-house IIF test was evaluated using the agreement Kappa test.  The purity of the three batches of MRC5 working seed cell at Human Viral Vaccine Department of Razi institute was verified using IIF and no contamination with continuous cell lines was detected

An Evaluation of the COVID-19 Pandemic and Perceived Social Distancing Policies in Relation to Planning, Selecting, and Preparing Healthy Meals: An Observational Study in 38 Countries Worldwide

Objectives: To examine changes in planning, selecting, and preparing healthy foods in relation to personal factors (time, money, stress) and social distancing policies during the COVID-19 crisis. Methods: Using cross-sectional online surveys collected in 38 countries worldwide in April-June 2020 (N = 37,207, Mage 36.7 SD 14.8, 77% women), we compared changes in food literacy behaviors to changes in personal factors and social distancing policies, using hierarchical multiple regression analyses controlling for sociodemographic variables. Results: Increases in planning (4.7 SD 1.3, 4.9 SD 1.3), selecting (3.6 SD 1.7, 3.7 SD 1.7), and preparing (4.6 SD 1.2, 4.7 SD 1.3) healthy foods were found for women and men, and positively related to perceived time availability and stay-at-home policies. Psychological distress was a barrier for women, and an enabler for men. Financial stress was a barrier and enabler depending on various sociodemographic variables (all p < 0.01). Conclusion: Stay-at-home policies and feelings of having more time during COVID-19 seem to have improved food literacy. Stress and other social distancing policies relate to food literacy in more complex ways, highlighting the necessity of a health equity lens. Copyright 2021 De Backer, Teunissen, Cuykx, Decorte, Pabian, Gerritsen, Matthys, Al Sabbah, Van Royen and the Corona Cooking Survey Study Group.This research was funded by the Research Foundation Flanders (G047518N) and Flanders Innovation and Entrepreneurship (HBC.2018.0397). These funding sources had no role in the design of the study, the analysis and interpretation of the data or the writing of, nor the decision to publish the manuscript.Scopu

A Comprehensive Investigation on the Influence of Zeolite, Pumice, and Limestone Powder on the Characteristics of Eco-Friendly Calcium Aluminate Cement Mixes

The current research aims to investigate the influence of pumice, zeolite, and limestone powder as supplementary cementitious materials (SCMs) on the characteristics of calcium aluminate cement (CAC) composites. For this purpose, SCMs were used in substitution levels of 5%, 15%, 25%, 40%, and 60% of CAC. The results indicate that the active SCMs had a great influence on enhancing the characteristics of the cement composites. For instance, the mixtures with 40% pumice and zeolite outperformed the plain mixture in the compressive strength test by about 45% and 90% at 90 days, respectively. At the age of 90 days, the rapid chloride migration coefficient for the optimal mixture of Z40 (containing 40% zeolite) was reduced by about 93%, and the electrical resistance was increased by about 70% in comparison to the age of 28 days; however, at the same ages, for the plain mixture, the rapid chloride migration coefficient was increased by about 74%, and the electrical resistance was decreased by about 60%. At the age of 90 days, the electrical resistivity of the Z40 mixture was 685% higher compared to the plain mixture. The results show that the high cost of CAC composite could be significantly lowered by utilizing SCMs. Moreover, using SCMs could significantly lower greenhouse gas emissions. In addition, the tests including the modulus of rupture, modulus of elasticity, permeable pore space, XRD, and microstructural analyses were also carried out to study the mechanical and durability properties. It must be mentioned that the effect of high dosages of pumice and zeolite on the durability properties of this type of cement has not been studied previously, which can be considered an innovation of this study. Furthermore, the obtained results could be beneficial to develop applications of CAC

Effect of Nutrition Education Program on the Recommended Weight Gain in during Pregnancy Application of Health Belief Model: A Randomaized Cilinical Trial

Background and Objectives: Nutrition in pregnancy has an important role in fetus and mother health, and also in the pregnancy outcome. One of the significant changes related to nutrition is weight gain of pregnant women as one of the influencing indicators which is measured by Body Mass Index (BMI). This study was conducted to determine nutritional education effect upon pregnancy weight gain in pregnant women on the basis of health belief model (HBM) in Gonabad, Iran.Methods: This is a quasi-experimental randomized and controlled study on 110 pregnant women referring to health centers in Gonabad, Iran. They were divided into experimental and control groups who participated in the study, in the year of 2009. The data of two groups were collected by reliable and valid questionnaires during the first part of pregnancy care in pre-test stage. Then, two educational sessions were held for the experimental group. Post test was done for both groups in the last stage of pregnancy care, and the data were analyzed by paired T, T independent, the correlation coefficient, Mann-Whitney, and Chi-square. A p<0.05 was considered to be significant.Results: No significant differences were found between the education, parity, abortion, jobs and the mean age of the two groups. After the intervention, the mean score of knowledge, perceived susceptibility, severity, threat, benefits and barriers and nutritional behavior in the experimental group, significantly changed in the control group (p<0.01). Moreover, statistical analyses showed a significant difference between the two groups in gaining recommended weight in pregnancy.Conclusion: While 77.78% of the experimental group members achieved recommend MBI, just 32.29% of those in the control group had a gain in this criterion. This study proved that HBM application in nutritional education was successfully effective to gain recommended weight in pregnancy, so that increasing suitable weight gain reached maximum and un-standardized weight gain reached minimum in accordance with women BMI

Kumaraswamy regression modeling for Bounded Outcome Scores

In this paper, we use a regression model for modeling bounded outcome scores (BOS), where the outcome is Kumaraswamy distributed. Similar to the Beta distribution, this distribution can take a variety of shapes while being computationally easier to use. Thus, it is deemed as a suitable alternative distribution to the Beta in modeling bounded random processes. In the proposed model, the median of a bounded response is modeled by the linear predictors which is defined through regression parameters and explanatory variables. We obtained the maximum likelihood estimates (MLE) of the parameters, provided closed-form expressions for the score functions and Fisher information matrix, and presented some diagnostic measures. We conducted Monte Carlo simulations to investigate the finite-sample performance of the MLEs of the parameters. Finally, two practical applications of this model to the real data sets are presented and discussed

Theranostic approach in liver cancer: an emerging paradigm to optimize personalized medicine

Purpose: This review aims to focus an update of the state-of-the-art theranostics approach in liver cancer using 131I, 32P, 90Y, 166Ho, and 186/188Re microspheres as well as some receptors including fibroblast activation protein (FAP), prostate-specific membrane antigen (PSMA), chemokine C-X-C motif receptor 4 (CXCR4), and somatostatin receptors (STR). Methods: A literature search was performed using the PubMed/MEDLINE and Clinical Trials.gov database and “liver”, “theranostics”, “transarterial radioembolization (TARE)”, “prostate-specific membrane antigen (PSMA)”, “fibroblast activation protein (FAP)”, “hepatocellular carcinoma”, “32P”, “90Y”, “166Ho”, “131I” and “somatostatin receptor (STR)” as keywords. Both, preclinical and clinical studies were included in this review. The search was restricted to the English language. Result: After exclusion of letters, editorials, comments and duplicates publications, remaining articles were included in this review. Conclusion: There is growing evidence for applicability of theranostic approach in these patients to enhance early identification, patient evaluation, targeted treatment, restaging, follow-up, and palliation of symptoms or slow down tumor progression. However, this field requires multidisciplinary expertise and collaboration. The increased access to tracers, training multidisciplinary teams, using novel trial designs, and establishing initiatives to share and re-analyze data from clinical imaging studies can encourage the use of molecular nuclear imaging in both clinical research and practical. It is also well recognized that dosimetric recommendations should be considered to compare promising new theranostic agents and clarify the better or similar performance of these methods in hepatocellular carcinoma.[Figure not available: see fulltext.]. © 2022, The Author(s), under exclusive licence to Italian Association of Nuclear Medicine and Molecular Imaging

Transplantation of a cadaveric liver allograft with right lobe cavernous hemangioma, without back-table resection: a case report

The use of extended criteria liver donors has become a necessity in an era of organ scarcity for transplantation. We present here a case report of orthotopic liver transplantation using a liver with a giant right lobe hemangioma without backtable resection. There were no data regarding the liver mass before organ procurement. The donor liver function tests and electrolyte profile were normal. During donor exploration a hemangioma was identified in segments V-VI, occupying approximately 20% of the total liver volume. It was prepared for transplantation on a sterile backtable without performing backtable hemangioma resection. A standard orthotropic liver transplant procedure was performed uneventfully, without veno-veno bypass. There was no bleeding from the hemangioma. The ischemic time was 9 hours and 20 minutes. Postoperative course was uneventful and the patient was discharged at 19 days after the operation. The hemangiomas showed evolution with some decrease in size upon later follow-ups. No clinically important complication was observed. Our case and other previous reports show that even large hemangiomas should not be considered to be a contraindication to organ procurement. These benign lesions either could be left in situ and observed or resected

Early hepatic artery thrombosis after liver transplantation: diagnosis and treatment

Hepatic artery thrombosis (HAT) occurs in 3% to 9% of all liver transplantations with acute graft failure as a possible sequel. Eleven episodes of HAT were identified among 256 orthotropic liver transplantations (whole, LDCT, split) performed on 253 patients between April 1993 and July 2006. HAT was suspected clinically and confirmed by Doppler ultrasonography, magnetic resonance angiography, angiography, or reexploration. One patient was excluded due to poor follow-up. Treatment options included exploration with HA thrombectomy plus thrombolysis, retransplantation, or conservative treatment of hepatic and biliary complications. Among 11 patients of mean age 29.98 +/- 17.14 years (range, 10 months to 56 years). 2 had split right lobe liver transplantations and 9 received whole organs. None of LDLTs were identified to have HAT. The causes of liver cirrhosis among HAT patients were autoimmune hepatitis (n=3), cryptogenic (n=3), Wilson (n=1), PBC (n=1), biliary atresia (n=1), and HBs (n=1). HAT was diagnosed at 5.9 +/- 4.43 (range, 2 to 16) days after operation. Most patients developed right upper quadrant (RUQ) pain at presentation. Two patients developed acidosis, fever, or SIRS and underwent retransplantation. Four underwent exploration of HA and 1 was treated conservatively. Three cases expired due to HAT complications. We found RUQ pain to be the presenting sign of early HAT in majority of cases. RUQ pain has been reported to occur in late HAT. Whenever HAT is confirmed, liver transplanted patients should be revascularized or even retransplanted. Intra-arterial thrombolysis and thrombolytic therapy for HAT should be done cautiously due to the potential risk of hemorrhage