Pleurodesis by erythromycin, tetracycline, Aerosil™ 200, and erythromycin plus Aerosil™ 200 in a rat model: a preliminary study

BACKGROUND: None of the current pleurodesing agents fulfil all the criteria for best pleural sclerosant. Therefore, the search for the ideal agent for chemical pleurodesis still continues. The aim of the present study was to compare the effectiveness of erythromycin, tetracycline, Aerosil™ 200 (hydrophilic fumed amorphous silica), and erythromycin plus Aerosil™ 200 in producing pleurodesis in rats. In the present study, talc was not used as a pleurodesing agent due to an unavailability of its sterile and pure form in Iran. METHODS: Overall, 75 adult male Spraque-Dawley rats were randomized to 5 treatment groups. Each group received an intrapleural injection via 5 Fr Silastic tubes of one of the following sterile agents: 35mg/kg erythromycin in 2 ml of saline, 35mg/kg tetracycline in 2 ml of saline, 35mg/kg Aerosil™ 200 in 2ml of saline, erythromycin (35mg/kg in 2 ml of saline) plus Aerosil™ 200 (35mg/kg in 2 ml of saline), or 2 ml of saline as a control. The animals were euthanized and necropsied 30 days after injection. The pleurae were assessed for macroscopic and microscopic evidence of surrounding inflammation and fibrosis. RESULTS: The median macroscopic score in the Aerosil™ 200 group was significantly higher than that in the erythromycin group (P < 0.005). The median microscopic score in the erythromycin group was significantly lower than that in the Aerosil™ 200 and erythromycin plus Aerosil™ 200 groups (P < 0.005). Furthermore, maximum and minimum pleural fibrosis was observed in the erythromycin plus Aerosil™ 200 and erythromycin groups, respectively (P < 0.05). CONCLUSION: This study suggests that Aerosil™ 200 with or without erythromycin may be more potent pleurodesis agent than erythromycin and tetracycline

Hormone Receptor Status in Breast Cancer and its Relation to Age and Other Prognostic Factors

Background Increasing evidence shows the importance of young age, estrogen receptor (ER), progesterone receptor (PR) status, and HER-2 expression in patients with breast cancers. Patients and methods We organized an analytic cross-sectional study of 105 women diagnosed with breast cancer who have been operated on between 2008 to 2010. We evaluated age, size, hormone receptor status, HER-2 and P53 expression as possible indicator of lymph node involvement. Results There is a direct correlation between positive progesterone receptor status and being younger than 40 ( P < 0.05). Also, compared with older women, young women had tumors that were more likely to be large in size and have higher stages ( P < 0.05). Furthermore patients with negative progesterone receptor status were more likely to have HER-2 overexpression ( P < 0.05). The differences in propensity to lymph node metastasis between hormone receptor statuses were not statically significant. Conclusions Although negative progesterone receptor tumors were more likely to have HER-2 overexpression, it is possible that higher stage and larger size breast cancer in younger women is related to positive progesterone receptor status

The frequenc of hearing loss etiology among deaf students in Chaharmahal va Bakhtiari province Iran 2008-2009

چکیده: زمینه و هدف: ناشنوایی شایع ترین اختلال حسی در انسان می باشد که تاثیرات اقتصادی و اجتماعی شدیدی در دنیای مدرن دارد. از نظر اتیولوژی، ناشنوایی به دو دسته ژنتیکی و غیر ژنتیکی تقسیم می شود که ناشنوایی ژنتیکی در دو گروه سندرمیک و غیر سندرمیک طبقه بندی می گردد. این مطالعه با هدف تعیین اتیولوژی ناشنوایی در دانش آموزان ناشنوای استان چهارمحال و بختیاری انجام شد. روش بررسی: در این مطالعه توصیفی 265 دانش آموز ناشنوای خفیف تا عمیق شرکت داشتند. نمونه ها شامل دانش آموزان ناشنوای مدارس استان چهارمحال و بختیاری بودند که دامنه سنی آنها بین 6 تا 22 سال بود. سابقه پزشکی، شجره نامه و اطلاعات دموگرافیک بیماران با استفاده از پرسشنامه جمع آوری گردید. تمام بیماران مورد معاینه عمومی و شنوایی قرار گرفته و تست Pure Tone Audiometry) PTA) برای کلیه دانش آموزان و تست ABR (Auditory Brainstem Response)، OAE(Otoacoustic Emissions) در بیماران مشکوک به ناشنوایی عصبی انجام شد. یافته ها: 2/67 از والدین دانش آموزان ناشنوا ازدواج خویشاوندی داشته و شایع ترین شکل این ازدواج، ازدواج بین خویشاوندان درجه 3 (1/78) بود. نتایج مطالعه نشان داد که 8/98 موارد ناشنوایی ژنتیکی به شکل اتوزمال مغلوب و در 8/97 موارد ناشنوایی از نوع حسی عصبی بود. از نظر اتیولوژی ناشنوایی با علت ژنتیکی، شایع ترین علت ناشنوایی(8/60) و سپس ناشنوایی با علل ناشناخته و اکتسابی بیشترین موارد را تشکیل می دادند. در 2/4 از دانش آموزان علل سندرمیک مطرح و مشکلات چشمی بیشترین ناهنجاری همراه با ناشنوایی بود. در بین علل اکتسابی نیز بیشترین عامل ناشنوایی به ترتیب مربوط به کرنیکتروس و تشنج همراه با تب بود. نتیجه گیری: نتایج این مطالعه اهمیت مشکلات مربوط به ازدواج های خویشاوندی را در جمعیت مورد مطالعه نشان می دهد. میزان این ازدواج ها در جمعیت مورد مطالعه بسیار بالا (2/67) بوده که می تواند علت اصلی ناشنوایی مادرزادی باشد

Effect of erythropoietin on inflammatory response and ischemic brain damage after carotid artery clamp in rat

Introduction: Erythropoietin (EPO) is reported to have a minimizing effect on the ischemic condition, but the detailed association between EPO and the ischemic upshot is still not clearly understood. We aimed to evaluate the effect of EPO on inflammatory response and ischemic brain damage after carotid artery clamp in rats. Methods: In this experimental, animal trial study, which was conducted at the Animal Facility and laboratory at Tabriz University of Medical Sciences, 50 adult male Wistar rats with (250 to 300 g) were randomly allocated to intervention and control groups. The intervention and control groups were administered intraperitoneally with equal volumes of EPO (5000 U/kg) and normal saline, respectively. Both groups had common carotid arteries clamped for 20 minutes. Using the Nissl staining technique, the slides of brain ischemic areas were observed and the rate of ischemic injury in both groups was determined. The blood level of inflammatory cytokines was also measured. Results: The levels of inflammatory markers including creatine phosphokinase (CPK), interleukin (IL)-6, IL-1B and tumor necrosis factor alpha (TNF)-α in the intervention group were significantly lower than that of control group. Mean percentage of the ischemic area in the intervention group with an amount of 4.30±2.15%, was significantly lower than that of control group (11.20±2.35%, P=0.023). Conclusion: Findings of this study showed that the injection of EPO before carotid clamping is effective in preventing cerebral ischemic injury in rats

Early and Late Results of Total Correction of Tetralogy of Fallot

The purpose of this study was to evaluate the early and late outcome after total correction of tetralogy of fallot (TOF) in 101 consecutive patients with a mean age of 8.23 &amp;plusmn; 4.90 years underwent repair of surgery at one institution between 1995 and 2006. Forty two patients had initial palliative operations. A transannular patch was inserted in 60 (58.5%) patients. Risk factors for operative mortality were analyzed. Follow-up was obtained from clinical appointments and telephone questionnaires. The operative mortality was 6.9%. Aortic cross-clamp time more than 90 minutes (P&amp;lt;0.01) and cardiopulmonary bypass time more than 120 minute (P&amp;lt;0.01), affected operative mortality, whereas previous palliative procedure, hematocrit level, and use of transannular patch did not. Mean follow-up is 34.08 &amp;plusmn; 31.09 months (range, 1 month to 120 months). Actuarial survival is 91% alive 10 years after total correction. On Postoperative echocardiography, 22 patients had mild pulmonary regurgitation, 19 had a right ventricular outflow tract gradient more than 50 mmHg, and 10 had a small residual ventricular septal defect. There were two late deaths. Late sudden death from cardiac causes occurred in one patients. Total correction of TOF can have low operative mortality and provide excellent long-term survival. This experience suggests that the key factor in the total correction of TOF is to correct the pathology completely, to protect the myocardium, and to manage the complication properly

Outcome of Systemic-to-Pulmonary Shunts in Cyanotic Congenital Heart Disease- A 9-year Experience

The aim of this study is to evaluate early and late results of surgery in children with congenital heart disease and decreased pulmonary blood flow, who underwent a palliative systemic-to-pulmonary shunt. During the past 9 years, 157 systemic-to-pulmonary artery shunts were performed in 130 patients (69 males, 61 females) with ages from 1 day to 31 years old. They had been evaluated for their clinical effectiveness, the need for a repeat operation and the mortality and morbidity. There were 101 (77.7%) modified Blalock-Tausig (BT) shunts, 19 (14.6%) modified Waterston shunts, 8 (6.2%) Central shunts, 1 Waterston shunt, and 1 Glenn shunt created throughout the study. Tetralogy of Fallot comprised the majority of cases (113; 86.9%) while the remaining 17 (13.1%) included transposition of the great arteries with pulmonary stenosis, tricuspid atresia, pulmonary atresia, atrioventricular septal defect (canal) with pulmonary stenosis, and univentricular heart complex. Early mortality was 12.3% (16 patients). Second shunts were created in 25 (19.2%) patients. Forty patients (30.8%) have undergone subsequent intracardiac repair 37.7 &amp;plusmn; 17.8 months after original shunt procedure. There were four (3%) late deaths. Follow-up was achieved in 105 of 114 early survivors for a pe-riod of 3 to 117 months (mean 31.7 &amp;plusmn; 19.4 months). Modified BT shunt was performed most frequently in our service; it was associated with less closure and mortality than other types of shunt and had excellent clinical palliation and patency rates

Comparison Thoracic Epidural and Intercostal Block to Improve Ventilation Parameters and Reduce Pain in Patients with Multiple Rib Fractures

Introduction: Chest wall blunt trauma causes multiple rib fractures and will often be associated with significant pain and may compromise ventilator mechanics. Analgesia has great roll in rib fracture therapies, opioid are useful, but when used as sole agent may re-quire such high dose that they produce respiratory depression, especially in el-derly .the best analgesia for a severe chest wall injury is a continuous epidural infusion of local anesthetic. This provides complete analgesia allowing inspiration and coughing without of the risk of respiratory depression. Methods: sixty adult patients who with multiple rib fractures were enrolled in this study. They were divided into Group A or thoracic epidural with bupivacaine 0.125 % +1mg/5ml morphine and group B or inter-costal block with %0.25 bupivacaine. The patients were assessed through ICU and hos-pital stay length, ventilation function tests. Pain score among the patients was meas-ured with verbal rating scale, before and after administration of the analgesia. Results: We found a significant improvement in ventilatory function tests during the 1st, 2nd, and 3rd days after epidural analgesia compared with the intercostal block (P < 0.004). Changes in the visual Analogue Scale were associated with marked improvement re-garding pain at rest and pain caused by coughing and deep breathing in group A com-pared group B... ICU and hospital stay markedly reduced in Group A. Conclusion: tho-racic epidural analgesia is superior to intercostals block regarding pain relief of rib frac-tures. Patients who received epidural analgesia had significantly lower pain scores at all studied times