Evaluating the MicroRNA Expression of IL-35 and IL-37 in Helicobacter pylori-infected Patients with Gastritis and Gastric Ulcer

Interleukin (IL)-35 and IL-37 are two anti-inflammatory cytokines. IL-35 inhibits the development of T-effector cells such as Th1, and Th17; while increasing regulatory T cells (Tregs). IL-37 causes the suppression of inflammatory cytokines. Regarding the positive impact of Helicobacter pylori (H. pylori) infection on inflammation and considering the anti-inflammatory effects of IL-35 and IL-37, this study aimed to evaluate the expression of these two cytokines in H. pylori-infected patients with gastrointestinal problems. The case group consisted of H. pylori-infected individuals with gastric ulcer and/or gastritis (n=50) and the control group consisted of cases with gastric ulcer and/or gastritis non -H. pylori infected (n=50). Sampling and classification of patients were based on pathology findings. A realtime polymerase chain reaction was performed for evaluating the IL-35 and IL-37 expression levels. H. pylori-infected gastritis patients showed lower expression of IL-35 and IL-37 than the non infected group. There was a significant difference between the expression levels of IL-35 and IL 37 in patients with gastric ulcers and/or gastritis who were infected and non-infected by H. pylori. There were no significant differences in the expression level of IL-35 and IL-37 in H. pylori infected patients with gastric ulcer or gastritis. Interleukins 37 and 35 were less expressed in patients with H. pylori-infection. In differentiation between patients with gastrointestinal symptoms who have H. pylori infection or with similar symptoms who do not have H. pylori-infection, mentioned interleukins can be used as diagnostic markers

Acquired von Willebrand Syndrome in a Male with Systemic Lupus Erythematosus Presented with Mucocutaneous Bleeding and Treated with rFVIIa

Aubert Marcel. Varille (Mathieu) et Dr Loison. L'abbaye de Saint-Chef en Dauphiné, 1929. In: Bulletin Monumental, tome 88, année 1929. pp. 546-547

Validity and reliability of the Persian version of MISSCARE survey

Background: The MISSCARE survey is a useful instrument measuring the amount and type of missed nursing care and its important reasons, developed by Kalisch and Williams in 2009 and revised in 2019. Objective: The present paper aimed to report the psychometric properties of part A (missed nursing care) and part B (reasons for missed nursing care) of the MISSCARE tool translated into Persian. Materials & Methods: A Persian version of the MISSCARE tool were evaluated by a panel of experts, and the psychometric properties were determined with 326 nurses randomly selected from non-emergency wards of seven educational and medical centers in Rasht, North of Iran. Nurses completed the instruments from January to March 2021. Content validity was evaluated by calculating content validity index (CVI). Confirmatory factor analysis (CFA) was used to assess construct validity. Internal consistency (reliability) was measured using Cronbach's alpha coefficient. Results: CVI was measured 0.82 and 0.79 for parts A and B of the survey. The fit indices of CFA indicated the acceptable fit for the measurement model of part B (missed nursing care reasons). Also, factor loadings of items on three factors of labor, material and communication confirmed the structural validity of part B of the survey. Cronbach’s alpha coefficients for parts A and B were 0.991 and 0.994 in whole, and Cronbach's alpha coefficient for three factors of part B ranged from 0.831 to 0.936 confirmed their reliability. Conclusions: The Persian version of the MISSCARE tool is valid and reliable for measuring missed nursing care and its reasons. It can be used by nursing authorities for evaluation purpose in Iranian hospitals

Acute kidney injury after cardiac surgery in the North of Iran

Introduction: Acute renal failure is a well-known complication in patients after cardiac surgery. Objectives: The determination of disease-causing factors with the aim of identifying patients at high-risk and implementing preventive care pre- and postoperatively to reduce the incidence of acute kidney injury (AKI) in patients after cardiac surgery. Patients and Methods: The present cross-sectional research was carried out on 512 adult patients who underwent cardiac surgery between 2015 and 2016 in our tertiary center. Demographic and laboratory data of patients were obtained using a checklist. AKI is defined as an increase of at least 0.3 mg/dL in creatinine (Cr) over 48 hours and one week after surgery according to acute kidney injury network (AKIN) and RIFLE (risk, injury, failure, loss of kidney function, and end-stage renal failure) criteria before surgery. All data were analyzed by SPSS version 1, and P value <0.05 was considered significant. Results: In this study we found, AKI risk profiles including serum Cr level [OR = 3.24, 95% CI = 1.92 -12.48, P = 0.001], fasting blood glucose [OR = 1.22, 95% CI = 1.09 -1.92, P = 0.03] and hemoglobin (Hb) before surgery (OR = 0.59, 95% CI = 0.08 -0.87, P = 0.04) were significantly associated with increased risk of acute renal injury (logistic regression analysis). Conclusion: The results indicated that changes in serum Cr level, fasting blood glucose and plasma Hb before cardiac surgery might be considered as the risk factors for AKI after cardiac surgery

Social death in patients: Concept analysis with an evolutionary approach

Social death is an important concept that should be considered in a wide range of patients, especially in chronic diseases. Despite, there is still no clear and comprehensive definition of social death in medicine. The present study was thus conducted with Rodgers' evolutionary concept analysis method to identify the key features and provide a clear definition of social death in patients and understand its background and consequences. Considering the stages of concept analysis, an initial search was carried out in scientific databases (PubMed, Science Direct, Google Scholar, Magiran, and SID) without time limit until 2020. The search resulted in 400 articles in the first stage, which were screened according to the study objective and, all the items and points consistent with the concept's attributes, antecedents, consequences, associated concepts, alternative terms and definition were extracted. According to the results of different studies, the attributes of social death in patients can be classified into three main themes: The loss of social identity, loss of social relations (social isolation), and deficiencies related to the inefficiency of the body and various diseases. Generally, antecedents' social death in patients can be including; the factors related to the patient, Family neglect, Medical personnel's treatment of the patient as a corpse, Having no social situation. Also, there is little information available about the effect of social death on the patients themselves and their families, specialists, health care institutions and the society. Mankind's perception of social death is multidimensional and may have consequences such as bad death, disgraceful death deprivation of belonging to the society, financial vulnerability, removed or weakened legal support, stigma, and the loss of social identity. The proper understanding of social death in patients not only determines the role and importance of care in the process of incidence of this phenomenon, but also paves the way for designing an evidence-based care program for its prevention and control

Thyroid Hormone Changes in Early Kidney Transplantation and Its Correlation with Delayed Graft Function

Introduction: Thyroid hormones affect kidney function and may alter with changes in kidney function, as well. We evaluated changes in serum levels of triiodothyronine (T3), thyroxin (T4), and thyroid-stimulating hormone (TSH) early after kidney transplantation and their relationship with delayed graft function (DGF). Materials and Methods: Fifty-five consecutive kidney allograft recipients were enrolled in the study. Serum levels of T3, T4, and TSH were measured on the day before transplantation, and also on posttransplant days 1, 3, 7, 14, and 21. Results were compared between patients with a normal allograft function and those with DGF. Results: The mean T3 level decreased from 110.41 ± 49.79 ng/dL before transplantation to 80.78 ± 51.42 ng/dL on the 1st day after transplantation (P = .04), while T4 reduction reached a significant level on the 3rd day after transplantation (8.27 ± 3.27µg/dL to 5.50 ± 2.57 µg/dL, P = .004). Patients with DGF experienced a significantly greater decrease in the serum level of T3 at the end of the 1st week after transplantation compared with patients with normal kidney function (P = .02). This significant decrease in T3 continued until the end of the 2nd week. Serum levels of T4 reduced comparably in the two groups, until the end of the 1st week, when it showed a significantly more reduction in the patients with DGF (P = .04). Conclusion: Both T3 and T4 reduced early after kidney transplantation, and this reduction was significantly more prominent in those with DGF. This is compatible with a consequence rather than a cause of DGF, explained in the setting of sick euthyroid syndrome