Family Members’ Attitudes Regarding Family Presence During Resuscitation of Adults: A Systematic Review and Meta Analysis

Context: Family presence during resuscitation (FPDR) is a controversial debate throughout the world. Experts believe that FPDRis a cultural and ethnical issue and that countries have different views regarding this matter. The aim of this study is a systematicreview and meta-analysis of all available studies assessing patient families’ views regarding their presence during resuscitation.Evidence Acquisition: Studies reported attitudes of the patients’ relatives toward FPDR were eligible for inclusion. Case reports,letters, opinion pieces, and reviews were excluded from the study. A systematic search was conducted in Medline, Embase, CINAHL,Cochrane library,Web of Science, SCOPUS, PsycInfo, and other related databases based on selected keywords. The qualities of studieswere assessed using Critical Appraisal Skills Programme (CASP) and STROBE statement. Comprehensive meta-analysis (version-2)was used for data analysis. Heterogeneity was assessed using the Cochrane Q-statistic and the I2 statistic. Publication bias was detectedthrough funnel plot.Results: A total of 18 studies were selected, including 10 cross-sectionals and 8 control trials. The results were categorized in threeitems: tendency for being present, satisfaction, and coping. A meta-analysis was done for 9 descriptive cross-sectional studies. Theevent rate of being present was 0.73 (95% CI: 0.60 - 0.83), which was statistically significant (P = 0.001), whereas the event rate ofcoping was 0.62 (95% CI: 0.48 - 0.73) and was not statistically significant.Conclusions: The results of this study showed that the patients’ families tend to be present during resuscitation and believe thatsome rules should support FPDR. In terms of anxiety disorders and PTSD, when there were more intervals, family’s presence andtheir emotional supports had a positive effect on them. However, the role of the medical staff cannot be ignored in this regard

Problem of Foreign Body in GI Tract

Most foreign bodies pass through the gastrointestinal tract uneventful. We report of a case of inadvertently ingested foreign body, which by endoscopy simulated a polyp and on biopsy reported as cancer, so the patient underwent an unnecessary major operation. This report emphasizes the importance of resemblance of foreign bodies with gastrointestinal neoplasm, and endoscopists, surgeons and pathologists should consider this entity in their daily practice

Sebaceous Lymphadenoma of Parotid: Imaging, Cytological, and Histological Findings in Detail

Sebaceous lymphadenomas are rare and account for less than 1% of primary salivary gland tumors. These rare tumors are mostly found in men older than 50 years. The clinicopathological features of these tumors are poorly understood and no definite causative factor has been reported for them till now. They are not often diagnosed prior to surgery, which could be due to their rarity and lack of enough preop radiological and cytological findings. Few case reports have been published in literature about their pathogenesis and accompanying malignant lesions. The cytological and imaging findings have been dealt with in some articles. Here we describe the histologic, cytologic, and radiologic findings of sebaceous lymphadenomas of parotid gland, all together, and discuss their differential diagnoses in various diagnostic methods

Juvenile ischemic stroke secondary to cardiogenic embolism: A rare case report

Myxomas, the most common primary cardiac tumors, are known as a source of cardiogenic emboli. The possibility of their early detection has made them of great importance for emergency medicines. Detection of the disease is probable at early stages using echocardiography and associate complications such as syncope, cerebral embolic ischemic strokes, and sudden death. We report experience of a rare case of juvenile acute stroke in a patient with cardiac myxoma affecting all cardiac chambers presenting to the emergency department. In young stroke patients with signs and symptoms compatible with cardiovascular involvement, cardiogenic emboli should be taken into consideration; early echocardiographic studies are highly recommended. Prompt myxoma resection is required in both asymptomatic and stroke patients in whom intravenous thrombolysis course has not been implemented due to any limitations

Universal Glove and Gown Use for Healthcare Workers: What Is the Role of Visitors?

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Risk Factors of HCV Seroconversion in Hemodialysis Patients in Tabriz, Iran

Background: Hepatitis C virus (HCV) infection is a significant health concern in patients with end-stage renal disease under dialysis. Epidemiological studies have reported a prevalence rate of 5.5-55.9% for this condition in Iran. Objectives: We evaluated the risk factors for HCV infection and seroconversion in hemodialysis patients. Patients and Methods: A retrospective analysis was performed on 455 hemodialysis patients from each of the five dialysis units in Tabriz, northwest Iran. Possible risk factors for HCV infection and seroconversion were evaluated. Results: A total of 37 patients were HCV positive (8.1% of the study population) and seroconversion occurred in 18 of them during the dialysis treatment (3.95% of the study population). History of renal transplantation (44.4%, P < 0.0001), surgical intervention (except for renal transplantation and AV fistula placement) (94.4%, P = 0.03), and mean duration of dialysis (106.06 ± 55.519, P < 0.0001) had strong statistically significant associations with the seroconversion. Conclusions: The current study indicates increased risk for HCV infection in patients under dialysis and its relation with the mean duration of hemodialysis, history of renal transplantation and surgical intervention. Considering the immune deficiency in these patients, intense education to both patients and medical staff will be beneficial

Optimization of activin-A. A breakthrough in differentiation of human induced pluripotent stem cell into definitive endoderm

The first step in differentiation of pluripotent stem cell toward endoderm-derived cell/organ is differentiation to definitive endoderm (DE) which is the central issue in developmental biology. Based on several evidences, we hypothesized that activin-A optimization as well as replacement of fetal bovine serum (FBS) with knockout serum replacement (KSR) is important for differentiation of induced pluripotent stem cell (iPSC) line into DE. Therefore, a stepwise differentiation protocol was applied on R1-hiPSC1 cell line. At first, activin-A concentration (30, 50, 70 and 100 ng/ml) was optimized. Then, substitution of FBS with KSR was evaluated across four treatment groups. The amount of differentiation of iPSC toward DE was determined by quantitative gene expression analyses of pluripotency (NANOG and OCT4), definitive endoderm (SOX17 and FOXA2) and endoderm-derived organs (PDX1, NEUROG3, and PAX6). Based on gene expression analyses, the more decrease in concentrations of activin-A can increase the differentiation of iPSC into DE, therefore, 30 ng/ml activin-A was chosen as the best concentration for the differentiation of R1-hiPSC1 line toward endoderm-derived organ. Moreover, complete replacement of FBS with gradually increased KSR improved the differentiation of iPSC toward DE. For this reason, the addition of 0% KSR at day 1, 0.2% at day 2 and 2% for the next 3 days was the best optimal protocol of the differentiation of iPSC toward DE. Overall, our results demonstrate that optimization of activin-A is important for differentiation of iPSC line. Furthermore, the replacement of FBS with KSR can improve the efficiency of iPSC differentiation toward DE