The effect of preoperative aspirin use on postoperative bleeding and perioperative myocardial infarction in patients undergoing coronary artery bypass surgery

Background: We tried to evaluate the clinical outcomes (mortality, postoperative bleeding and perioperative myocardial infarction) of patients who underwent first elective coronary artery bypass grafting and received aspirin during the preoperative period. Methods: The study was a prospective, randomized and single-blinded clinical trial. Two hundred patients were included and divided into two groups. One group received aspirin 80-160 mg, while in the other aspirin was stopped at least seven days before surgery. The primary end-points of the study were in-hospital mortality and hemorrhage-related complications (postoperative blood loss in the intensive care unit, re-exploration for bleeding and red blood cell and non-red blood cell requirements). The secondary end-point was perioperative myocardial infarction. Results: There were no differences in patient characteristics between the aspirin users and non-aspirin users. We found a significant difference between postoperative blood loss (608 ± ± 359.7 ml vs. 483 ± 251.5 ml, p = 0.005) and red blood cell product requirements (1.32 2+ ± 0.97 unit packed cell vs. 0.94 ± 1.02 unit packed cell, p = 0.008). There was no significant difference between the two groups regarding platelet requirement and the rate of in-hospital mortality and re-exploration for bleeding. Similarly, we found no significant difference in the incidence of definite and probable perioperative myocardial infarction (p = 0.24 and p = 0.56 respectively) or in-hospital mortality between the two groups. Conclusion: Preoperative aspirin administration increased postoperative bleeding and red blood cell requirements with no effect on mortality, re-exploration rate and perioperative myocardial infarction. We recommend withdrawal of aspirin seven days prior to surgery. Copyright © 2007 Via Medica

Patients� satisfaction with healthcare services providers and its determinants in the urban family physician program in Iran: A cross-sectional study

Introduction: The quality of healthcare services can be determined by patient satisfaction as it affects the performance, sustainability, and durability of health services. This study aims to determine patients� satisfaction with healthcare service providers and its determinants in the urban family physician program in Fars and Mazandaran provinces, Iran. Methods: A cross-sectional study was conducted on the populations covered by the urban family physician program in Fars and Mazandaran provinces in 2016. In total, 864 households were selected in each province using random cluster sampling. Socio-demographic variables and underlying factors were gathered. Patient satisfaction levels were evaluated using a validated questionnaire. Results: Of the 1,480 participants with a mean age of 46.9 ± 14.2 years, 53.3 lived in Fars province and 74.2 were female. Furthermore, 67.9 of the patients were satisfied with their healthcare service providers. A higher satisfaction level was observed among the patients who resided in Fars province, lived in cities with <100,000 residents, walked <10 minutes to the family physician�s office, had a family physician they previously knew, accepted the family physician, had a positive attitude towards the importance of having a family physician and a referral system, and had adequate knowledge of the family physician program. Conclusion: The results indicated that two-thirds of the patients were satisfied with healthcare service providers. Several socio-demographic variables were associated with the patients� satisfaction levels. Improving the family physician program by providing adequate medical equipment and monitoring physicians� performance could increase patient satisfaction and improve the sustainability of the program. © 2022, Academy of Family Physicians of Malaysia. All rights reserved

Effective factors on the utilization of health population covered by the urban family physician program in Iran

Introduction: The urban family physician program for increase the utilization of health services has been implemented in Fars and Mazandaran provinces since 2012. In this way, this study aimed to determine the benefit level for population covered by the urban family physician program in Iran. Materials and Methods: This cross-sectional study was conducted in 2017. Participants on the households covered by the urban family physician program; were selected by random cluster sampling. The data collection tool was a researcher-made questionnaire consisting of 2 parts: individual variables and benefit level of health services with 33 open and closed questions; its validity and reliability were confirmed. Results: Among 1768 households with a population of 5628 people, 5521(98.1) had one type of basic insurance. 0.31 of the people who had supplementary insurance. The average time between the home and the work place for the family physician was 18.6±18.9 minutes on foot and 5.7±5.1 by car. Correspondingly, 75.8 of those who had basic insurance were visited at least once by their family physician. The average family physician visits for participants over 15 years old was 5.14 times per year. Factors such as health records, household size, supplementary insurance, illness, education, occupation, physician replacement, availability time, and familiarity with the Family Physician Program were effective in terms of coverage of the affected population with a meaningful level (P<0.05). Conclusion: This study showed that all covered individuals did not benefit from the urban family physician program, and a number of individual factors influenced the benefit of the urban family physician program. © 2020, Semnan University of Medical Sciences. All rights reserved

ST8 micellar/niosomal vesicular nanoformulation for delivery of naproxen in cancer cells: Physicochemical characterization and cytotoxicity evaluation

Naproxen (NPX) is a non-steroidal anti-inflammatory drug (NSAID) used against a variety of diseases, including autoimmune disorders and chronic inflammations. However, low water solubility limits its therapeutic efficacy and novel nanoformulations are required to bypass its poor bioavailability to reach its therapeutic effect. The purpose of the study was to investigate the role of the nanoformulation of biocompatible molecules; Squalene (S) and Tween 80 (T8) Micellar/Niosomal Vesicles (ST8MNV) prepared, by thin-film hydration method and their potential as a drug delivery system for NPX. The percentage of encapsulation efficiency was calculated to be 99.5 ± 0.2 for 5 of NPX weight in total ingredients of micellar/niosomal vesicles (w/w). The ST8MNV nanoformulation exhibited a slower rate of NPX release from the drug encapsulated over seven days, suggesting a stable complex of NPX. Finally, cell toxicity assay demonstrated that the half-maximal inhibitory concentrations (IC50) of NPX were drastically reduced by ST8MNV nanoformulation in MCF-7, A549, HeLa, and MDA-MB-231 cancer cell lines. Our data show this micellar/niosomal naproxen nanoformulation is a great candidate for the future in vitro and in vivo studies for potential clinical anti-inflammatory and anticancer applications. © 2020 Elsevier B.V

Correction to: Plasma retinol-binding protein-4 and tumor necrosis factor-α are reduced in postmenopausal women after combination of different intensities of circuit resistance training and Zataria supplementation (Sport Sciences for Health, (2019), 15, 3, (551-558), 10.1007/s11332-019-00544-2)

International audienceUnfortunately, the 4th author name was incorrectly published in the original publication. The complete correct name should read as follows: Seyyed Pouya Jafari Hokmabad

Plasma retinol-binding protein-4 and tumor necrosis factor-α are reduced in postmenopausal women after combination of different intensities of circuit resistance training and Zataria supplementation

International audiencePurpose - Methods - Seventy-two postmenopausal women were divided on randomized order into six groups: Control (McGinley and Bishop in J Appl Physiol 121(6):1290-1305, 2016), Training 35% (T35%), Training 55% (T55%), Zataria (Özgünen et al. in Scand J Med Sci Sports 20:140-147, 2010), Zataria/Training 35% (ZT35%), and Zataria/Training 55% (ZT55%). Resist-ance training program included 12 exercise stations (each: 30 s, intensity: 35% and 55% of 1-RM) for 8 weeks (3 sessions/week). Daily (500 mg) was used after breakfast by participants in , ZT35%, and ZT55% groups. Blood samples were taken 48 h before and after the first and last sessions of training. Results - After the training period the percentage of body fat decreased significantly ( < 0.001) in all trained groups, whereas muscle mass increased significantly ( < 0.01) only in T55% and ZT55% groups. A significant decrease was observed for RBP-4 values ( < 0.05) after training in all groups except for ZG and CG. Also, RBP-4 was significantly lower ( < 0.05) in all groups as compared to CG at the post-test except for ZG. Moreover, significantly lower values ( < 0.05) were found in T55%, ZT35%, and ZT55% as compared to ZG in post-intervention. TNF-α values decreased significantly ( < 0.05) at the post-test as compared to pre-intervention in ZT35% and ZT55%. Also, TNF-α was significantly lower ( < 0.05) in ZT55% compared to CG and T35% in post-test. Conclusions - The results demonstrate clearly that in postmenopausal women, circuit resistance training both at low and moderate intensities cause a greater reduction in RBP-4 and TNF-α when is supplemented in the diet during training