Microbiome profile associated with malignant pleural effusion.

INTRODUCTION:There is ongoing research into the development of novel molecular markers that may complement fluid cytology malignant pleural effusion (MPE) diagnosis. In this exploratory pilot study, we hypothesized that there are distinct differences in the pleural fluid microbiome profile of malignant and non-malignant pleural diseases. METHOD:From a prospectively enrolled pleural fluid biorepository, samples of MPE were included. Non-MPE effusion were included as comparators. 16S rRNA gene V4 region amplicon sequencing was performed. Exact Sequence Variants (ESVs) were used for diversity analyses. The Shannon and Richness indices of alpha diversity and UniFrac beta diversity measures were tested for significance using permutational multivariate analysis of variance. Analyses of Composition of Microbiome was used to identify differentially abundant bacterial ESVs between the groups controlled for multiple hypothesis testing. RESULTS:38 patients with MPE and 9 with non-MPE were included. A subgroup of patients with metastatic adenocarcinoma histology were identified among MPE group (adenocarcinoma of lung origin (LA-MPE) = 11, breast origin (BA-MPE) = 11). MPE presented with significantly greater alpha diversity compared to non-MPE group. Within the MPE group, BA-MPE was more diverse compared to LA-MPE group. In multivariable analysis, ESVs belonging to family S24-7 and genera Allobaculum, Stenotrophomonas, and Epulopiscium were significantly enriched in the malignant group compared to the non-malignant group. CONCLUSION:Our results are the first to demonstrate a microbiome signature according to MPE and non-MPE. The role of microbiome in pleural effusion pathogenesis needs further exploration

Spiritual health nurses working in hospitals and critical care departments of Ilam city in 2015

سابقه و اهداف: پرستاران به‌­طور مستقیم با بیماران در ارتباط هستند. اگر پرستاران دارای سلامت معنوی بالایی باشند، بیش­تر از بیماران مراقبت خواهند کرد. ازاین­رو، هدف از این پژوهش، بررسی سلامت معنوی پرستاران در بخش­‌های ویژه‌­ی بیمارستان­‌های آموزشی شهر ایلام بوده است. مواد و روش‌ها: با استفاده از روش پژوهش توصیفی- همبستگی، پرسش­نامه‌­یی 20 سئوالی درباره‌­ی سلامت معنوی بر اساس دیدگاه اسلام، طراحی شد. با روش نمونه­‌گیری در دسترس، 60 نفر از پرستاران بخش­‌های ویژه­ی بیمارستان­‌های آموزشی شهر ایلام انتخاب شدند. پرسش­نامه­ی مورد استفاده­ به­صورت لیکرت شش گزینه­یی طراحی شده است. در مجموع بازه­ی نمره­‌های آزمودنی­‌ها بین 20 -120 به­دست آمد که در چهار دسته تقسیم­‌بندی شد؛ و برای تحلیل داده‌­ها نیز از نرم‌­افزار SPSS استفاده شد. یافته‌ها: %58 از نمونه­‌ها، زن بودند و %42، مرد. هیچ ­یک از پرستاران، نمره­‌ی کم(20- 40) کسب نکردند و 10 نفر از پرستاران(17%) نمره­‌ی متوسط رو به پایین(41- 70) به­‌دست آوردند. نمره­ی 30 نفر از پرستاران(50%) متوسط رو به بالا(71- 99) شد و در نهایت، 20 نفر از پرستاران(33%) نمره­‌ی بالا(120- 100) به­‌دست آوردند. نتیجه نشان داد که بین نمره­‌ی کل سلامت معنوی و جنسِ آزمودنی­‌ها، ارتباط معنی­دار وجود دارد(05/0P Value<). نتیجه‌گیری: بیش­تر پرستاران نمره‌­ی سلامت معنوی بالایی کسب کردند، که نشان می­‌دهد، می­توان با برنامه­‌ریزی مناسب، از سلامت معنوی پرستاران برای مراقبت معنوی از بیماران بهره برد.  Background and Objectives: Nurses communicate directly with patients. if they have higher spiritual health provide more care to patients. The aim of this study was to investigate the spiritual health of nurses in the critical departments of hospitals in Ilam. Materials and Methods: Using descriptive correlation study, a questionnaire with 20 questions about spiritual health was designed from the Islamic perspective. 60 nurses working at Critical care department of Ilam hospitals were selected by available sampling . The questionnaire was designed for six options Likert scale. Scores of participants were between 20 -120 which were divided into 4 categories. SPSS software was used for data analysis. Results: 42% and 58%of samples were  male and female, respectively. None of the nurses had low score (40-20), 10 nurses (17%) received the lower-middle score (70-41), 30 nurses (50%) and 20 nurses (33%) achieved the upper-middle (99-71) and high score (120-100), respectively. The results showed that there was a significant correlation between the total number of spiritual health and gender(P Value<0.05 ). Conclusion: More nurses received a high score of spiritual health. This results show that with proper planning, it can be benefit  for the pastoral care of the patient

Comparison of Properties of Breads Enriched with Omega-3 Oil Encapsulated in β-Glucan and Saccharomyces cerevisiae Yeast Cells

  Background and objective: Flaxseed oil, as a potential source of polyunsaturated fatty acids, is susceptible to oxidation. Yeast cells of Saccharomyces cerevisiae and β-glucan can be used as biocompatible and biodegradable matrices for the protection of this nutritious oil from oxidation in foods enriched with omega-3 fatty acids. The aim of this study was to investigate quality properties of breads containing encapsulated and free flaxseed oils. Materials and methods: Flaxseed oil was encapsulated in either yeast cells or β-glucan. Functional wheat bread samples were prepared using unencapsulated and encapsulated flaxseed oils. These were compared with control samples in terms of dough rheological and bread quality parameters. Results and conclusion: Encapsulation significantly increased dough rheological properties (G′ and G″ values), firmness and density and decreased lightness, compared to control samples. Breads, containing flaxseed oil encapsulated in yeast cells, showed a lower peroxide index and a higher α-linolenic acid value, compared to two other samples containing oil samples. This showed a better protection of unsaturated fatty acids against deleterious oxidation reactions. Results of this study indicate that addition of microencapsulated flaxseed oil into breads helps preserve sensory properties of the control sample, compared to breads fortified with free flaxseed oil. Conflict of interest: The authors declare no conflict of interest

The Use of Bronchoscopy During the COVID-19 Pandemic: CHEST/AABIP Guideline and Expert Panel Report

BACKGROUND: The coronavirus disease 2019 (COVID-19) has swept the globe and is causing significant morbidity and mortality. Given that the virus is transmitted via droplets, open airway procedures such as bronchoscopy pose a significant risk to health-care workers (HCWs). The goal of this guideline was to examine the current evidence on the role of bronchoscopy during the COVID-19 pandemic and the optimal protection of patients and HCWs. RESEARCH QUESTION: ▪▪▪ STUDY DESIGN AND METHODS: A group of approved panelists developed key clinical questions by using the Population, Intervention, Comparator, and Outcome (PICO) format that addressed specific topics on bronchoscopy related to COVID-19 infection and transmission. MEDLINE (via PubMed) was systematically searched for relevant literature and references were screened for inclusion. Validated evaluation tools were used to assess the quality of studies and to grade the level of evidence to support each recommendation. When evidence did not exist, suggestions were developed based on consensus using the modified Delphi process. RESULTS: The systematic review and critical analysis of the literature based on six PICO questions resulted in six statements: one evidence-based graded recommendation and 5 ungraded consensus-based statements. INTERPRETATION: The evidence on the role of bronchoscopy during the COVID-19 pandemic is sparse. To maximize protection of patients and HCWs, bronchoscopy should be used sparingly in the evaluation and management of patients with suspected or confirmed COVID-19 infections. In an area where community transmission of COVID-19 infection is present, bronchoscopy should be deferred for nonurgent indications, and if necessary to perform, HCWs should wear personal protective equipment while performing the procedure even on asymptomatic patients

Recent advances in the management of non-small cell lung cancer [version 1; referees: 2 approved]

Lung cancer is the number one cause of cancer-related death in both men and women. However, over the last few years, we have witnessed improved outcomes that are largely attributable to early detection, increased efforts in tobacco control, improved surgical approaches, and the development of novel targeted therapies. Currently, there are several novel therapies in clinical practice, including those targeting actionable mutations and more recently immunotherapeutic agents. Immunotherapy represents the most significant step forward in eradicating this deadly disease. Given the ever-changing landscape of lung cancer management, here we present an overview of the most recent advances in the management of non-small cell lung cancer

Hepatic Hydrothorax and Congestive Heart Failure Induced Pleural Effusion

Pleural effusions (PEs) are frequently encountered in routine clinical practice, affecting more than 3000 people per million population every year. Heart and liver failures are two of the most common causes of transudative PE. Because these effusions have nonmalignant etiologies, they are commonly referred to as benign effusions despite of the poor prognosis they foretell in their refractory stages. Like malignant effusions, symptom management is important and plays a significant role in palliation when these effusions become refractory to medical therapy

Safety of Propofol versus Nonpropofol-Based Sedation in Children Undergoing Gastrointestinal Endoscopy: A Systematic Review and Meta-Analysis

Background. The majority of children who undergo gastrointestinal (GI) endoscopy require anesthesia or procedural sedation for comfort, cooperation, and procedure efficiency. The safety profile of propofol is not well established in children but has been studied in the literature. Objective. The aim of this study is to evaluate and compare the safety of propofol-only sedation for GI endoscopy procedures to other anesthetic regimes in the pediatric population. Methods. A search was conducted in the MEDLINE, Embase, and Cochrane Library databases. Randomized clinical trials and prospective cohorts were included in the study. Results. No significant difference was noted in total complications between the two cohorts with a pooled OR of 1.31 (95% CI: 0.57–3.04, chi2 = 0.053, I2 = 54.31%). The pooled rate of complications in the studies was 23.4% for those receiving propofol only and 18.2% for those receiving other anesthetic regimens. Sensitivity analysis was performed removing a study with a very different control comparison compared to the rest of the studies included. Once excluded, there was minimal heterogeneity in the remaining studies and a significant difference in overall complications was detected, with more complications seen in the propofol-only group compared to the other anesthetic groups (OR 1.87, 95% CI 1.09–3.20). Conclusion. Significantly higher incidence of cardiorespiratory complications was noted in the propofol-only versus other anesthetic regimens in pediatric patients undergoing GI endoscopy in this meta-analysis. However, the overall quality of the evidence is very low. How to Apply This Knowledge for Routine Clinical Practice. Clinicians providing sedation to a pediatric population for GI endoscopy should consider there may be increased risks when using a propofol-only regimen, but further study is needed