Intravenous Pamidronate for Refractory Lymphedema

Background: Based on beneficial reports of pamidronate use for reflex sympathetic dystrophy in reduction of pain and swelling, this drug can be studied as a novel treatment for refractory lymphedema. This study aims to determine the effectiveness of pamidronate on lymphedema and its possible side effects. Methods: Twelve cases of lower limb refractory lymphedema were enrolled. They received intravenous pamidronate monthly for 3 consecutive months and were followed by measuring any discomfort with visual analog scale (VAS) and physician global assessment, based on objective signs of limb volume and circumference. Results: The limb volume, circumference, and satisfaction of the patients improved significantly. Conclusion: Pamidronate when is added to conservative treatments may reduce lymphedema and improve the patient's comfort. © Iranian Red Crescent Medical Journal

Investigating Physical and Mechanical Properties of Bionanocomposite Film Based on Flaxseed Mucilage and Cellulose Nanocrystal

Introduction  Manufacturers are trying to replace plastic materials in the food packaging industry with biodegradable and edible films. Biodegradable edible films and coatings are mainly made from carbohydrates, lipids and proteins and their mixtures. In recent decades, various carbohydrates from plant sources have been investigated and introduced as new compounds for the preparation of these films. Flaxseed gum is a white to cream-colored powder that dissolves in water and produces a gel, and is a desirable compound for forming films and coatings. Recently, through the integration of reinforcements or fillers with at least one nanometer dimension in the substrate of one or more natural biopolymers, the physicochemical, mechanical, optical, thermal and barrier properties of pure biofilms have been improved. The use of cellulose nanoparticles in biofilms as a reinforcing agent for polymer materials leads to the creation of composite films with better quality characteristics and leads to the creation of functionalization activities in film production. Therefore, the aim of this research was to produce and characterize edible and biodegradable film based on the combination of flaxseed gum and cellulose nanocrystals.   Materials and Methods  Cellulose nanocrystals (Degree of crystallinity: 42% and average particle size: 58 nm) were extracted from cotton linters. Glycerol and other chemicals used for this research were obtained from Merck, Germany. Flaxseeds were purchased from the local market of Shiraz (Iran). Bionanocomposite films were prepared from different ratios (0:100, 30:70, 50:50, 70:30 and 100:0) of flaxseed mucilage (2% w/v) and cellulose nanocrystal (6% w/v) solutions. The prepared solutions were poured on a petri dish with a diameter of 15 cm and dried in an oven at 80°C for 4 hours. Their physical, color and mechanical properties were investigated and the best ratio was selected for the preparation of bionanocomposite film. The produced films were subjected to different analysis to determine thickness, solubility, water absorption capacity, permeability to water vapor, tensile strength, elongation at break point, and colorimetry. The microstructure of the produced film was studied using a scanning electron microscopy (SEM).The average data were analyzed by analysis of variance in a completely randomized design using SPSS 22.0 software. Differences between treatments were expressed in Duncan's multiple range test at the 95% probability level (p<0.05) and the corresponding graphs were drawn with Excel 2013.   Results and Discussion  The results of the film thickness test showed that the film containing 100% mucilage has the lowest thickness and with the addition of cellulose nanocrystals, the thickness increased significantly (p<0.05). The results of the water solubility and water absorption capacity of the film samples showed that the addition of cellulose nanocrystals to the flaxseed mucilage film initially led to a significant decrease in the water solubility and water absorption capacity (p<0.05), so that the lowest level ofthese two physical parameters were obtained in the film containing the combination of 70% flaxseed mucilage and 30% cellulose nanocrystal, and then with the increase of cellulose nanocrystals, an increase in water solubility and water absorption capacity of the films was observed. Nanocrystal cellulose at low levels (30%) acted as a filler and was uniformly dispersed in the network of the film and by filling the empty pores of the biopolymer film based on flaxseed mucilage, it caused the transfer of water vapor more complicated and reduced the permeability to water vapor. However, its higher amount increased the permeability of the film to water vapor.The results showed that by adding cellulose nanocrystal to the film based on flaxseed mucilage and increasing its amount, the brightness of the films decreased and the intensity of redness, yellowness and turbidity of the films increased significantly (p<0.05). By combining flaxseed mucilage and cellulose nanocrystals in a ratio of 30:70, the best film was produced in terms of mechanical strength and stability against moisture and water vapor. The SEM image of this film showed a smooth, even surface and a uniform distribution of cellulose nanocrystals in the film network.   Conclusion  The results finally showed that the combination of flaxseed mucilage and cellulose nanocrystals in a ratio of 30:70 was able to produce a biodegradable and edible film with favorable structural and barrier properties. The characteristics of this film include; thickness (0.313mm), solubility (53.42%), water absorption capacity (44.44%), permeability to water vapor (0.350 g.m-1s-1Pa-1 × 10 -10), tensile strength (0.973 MPa), elongation at break point (30.52%) were obtained. The colorimetric indices L*, a*, b* and turbidity were determined as 79.73, 1.95, 3.48 and 1.335 mm-1 respectively.   Acknowledgement  The authors would like to express their sincere gratitude to Islamic Azad University, Sarvestan Branch

Evaluating the Safety Impacts of Increased Speed Limits on Freeways in Kansas Using Before-And-After Study Approach

In the summer of 2011, a change in the Kansas laws came into effect, increasing the speed limit on a selected set of freeway sections from 70 mph to 75 mph. Higher speeds were thought to have economic benefits, mostly because the travel time reduction means people reach their destinations more quickly. In this study, the sections where the speed limits remained unchanged, are compared to freeway sections that have been influenced by speed limit increase, to evaluate safety effectiveness. The study utilizes the before-and-after study with comparison group method to assess the safety effects provided in the Highway Safety Manual (HSM). Two crash datasets, obtained by considering three years before and three years after the speed limit increase, were compared in order to evaluate the safety effects of the speed limit change. The crash modification factors (CMFs) were estimated, which showed that there was a 27% increase in total crashes and a 35% increase in fatal and injury crashes across all sections after the speed limit change, and these increases were statistically significant at 95% confidence level. These confounding results show that the speed limit increase has not been beneficial for traffic safety in Kansas, and hence it is important to be cautious in such future situations. Also, additional data have been presented which would be beneficial in identifying and understanding any behavior change in drivers following a speed limit increase