Lung cancer risk and the inhibitors of angiotensin converting enzyme; an updated review on recent evidence

The renin-angiotensin-aldosterone system (RAAS) has a significant act in the pathology of blood pressure and cancer. One of the dominant sections of angiotensin II (Ang II) and angiotensin-converting enzyme (ACE) expression generation in the human body is the capillary veins in the lung. Changes in the expression of RAAS were revealed to be included in several lung diseases. There are several studies on the anticancer effect of ACE inhibitors; however, Hicks and colleagues reported an augmented risk of 14% for advancing lung cancer for patients consuming ACE inhibitors against angiotensin receptor blockers (ARBs) administration. Several lines of evidence indicated that ARB users have a lower risk of tumor progression and metastasis and progression of lung cancer. This review has surveyed some studies about the study by Hicks et al with conflicting results. Some Hicks’s study limitations are summarized here such as genetic effects, comparative study, residual confounding factors such as smoking, detection bias owing to cough, and socio-economic status. It is suggested some natural alternatives to ACE Inhibitors in here.publishedVersio

Effects of Problem, Intervention, Evaluation (PIE) Training on the Quality of Nursing Documentation Among Students of Hamadan University of Medical Sciences, Hamadan, Iran

Background: Documentation of nursing care is one of the most important professional responsibilities of nurses and one of the major components of medical care and patient record documentation. Objectives: The present study was performed to determine the effect of problem, intervention, evaluation (PIE) training on the quality of nursing students' documentation. Methods: In this semi-experimental single-group study with a pretest-posttest design, a total of 28 nursing students were selected by simple random sampling. The data collection tools included a demographic questionnaire, PIE documentation form, and documentation quality checklist. First, the students were asked to write two reports using the traditional or narrative method. Then, a training workshop was organized about PIE documentation, and the students were asked to use this method and write two more reports about the same patient on two consecutive days; overall, each student presented four reports. A total of 112 reports were analyzed using descriptive statistics and paired t test in SPSS. Results: Based on the results of paired t test, there was a significant difference in the mean score of documentation quality between the pretest and posttest (P < 0.001). Also, there was a significant difference in the mean score of documentation quality between the pretest and posttest in terms of both report structure and content (P < 0.001). Conclusions: Use of PIE reporting system improves the quality of nursing documentation. Therefore, it can be a suitable alternative for the current narrative or traditional method. Keywords Nursing Documentation Problem-Based Reporting Nursing Student

The efficacy of machine learning models in forecasting treatment failure in thoracolumbar burst fractures treated with short-segment posterior spinal fixation

Abstract Background Although short-segment posterior spinal fixation (SSPSF) has shown promising clinical outcomes in thoracolumbar burst fractures, the treatment may be prone to a relatively high failure rate. This study aimed to assess the effectiveness of machine learning models (MLMs) in predicting factors associated with treatment failure in thoracolumbar burst fractures treated with SSPSF. Methods A retrospective review of 332 consecutive patients with traumatic thoracolumbar burst fractures who underwent SSPSF at our institution between May 2016 and May 2023 was conducted. Patients were categorized into two groups based on treatment outcome (failure or non-failure). Potential risk factors for treatment failure were compared between the groups. Four MLMs, including random forest (RF), logistic regression (LR), support vector machine (SVM), and k-nearest neighborhood (k-NN), were employed to predict treatment failure. Additionally, LR and RF models were used to assess factors associated with treatment failure. Results Of the 332 included patients, 61.4% were male (n = 204), and treatment failure was observed in 44 patients (13.3%). Logistic regression analysis identified Load Sharing Classification (LSC) score, lack of index level instrumentation, and interpedicular distance (IPD) as factors associated with treatment failure (P < 0.05). All models demonstrated satisfactory performance. RF exhibited the highest accuracy in predicting treatment failure (accuracy = 0.948), followed by SVM (0.933), k-NN (0.927), and LR (0.917). Moreover, the RF model outperformed other models in terms of sensitivity and specificity (sensitivity = 0.863, specificity = 0.959). The area under the curve (AUC) for RF, LR, SVM, and k-NN was 0.911, 0.823, 0.844, and 0.877, respectively. Conclusions This study demonstrated the utility of machine learning models in predicting treatment failure in thoracolumbar burst fractures treated with SSPSF. The findings support the potential of MLMs to predict treatment failure in this patient population, offering valuable prognostic information for early intervention and cost savings

Lung cancer risk and the inhibitors of angiotensin converting enzyme; an updated review on recent evidence

The renin-angiotensin-aldosterone system (RAAS) has a significant act in the pathology of blood pressure and cancer. One of the dominant sections of angiotensin II (Ang II) and angiotensin-converting enzyme (ACE) expression generation in the human body is the capillary veins in the lung. Changes in the expression of RAAS were revealed to be included in several lung diseases. There are several studies on the anticancer effect of ACE inhibitors; however, Hicks and colleagues reported an augmented risk of 14% for advancing lung cancer for patients consuming ACE inhibitors against angiotensin receptor blockers (ARBs) administration. Several lines of evidence indicated that ARB users have a lower risk of tumor progression and metastasis and progression of lung cancer. This review has surveyed some studies about the study by Hicks et al with conflicting results. Some Hicks’s study limitations are summarized here such as genetic effects, comparative study, residual confounding factors such as smoking, detection bias owing to cough, and socio-economic status. It is suggested some natural alternatives to ACE Inhibitors in here

بررسی حساسیت اخلاقی و پریشانی اخلاقی در پرستاران مراقب بیماران مبتلا به Covid-19 در مراکز آموزشی درمانی دانشگاه علوم پزشکی همدان

Abstract&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Title:Investigating moral sensitivity and moral distress in nurses caring for patients with COVID-19 in medical training centers of Hamedan University of Medical Sciences Background: &nbsp;Moral sensitivity enables nurses to interpret the needs of their clients and respond to them according to ethical principles, which can play an important role in preventing situations that cause moral distress. Moral distress is a well-known phenomenon in the nursing profession that can cause a lot of physical and mental stress on nurses and cause them to be dissatisfied, reducing the efficiency and quality of care. Therefore, the present study was conducted with the aim of determining moral sensitivity and moral distress in nurses caring for patients with COVID-19 in medical training centers affiliated to Hamedan University of Medical Sciences in 2019. Materials and methods: The current research is a descriptive-analytical study that was conducted on 180 nurses of Hamadan University of Medical Sciences in 2019 by stratified random sampling method. The data collection tools included a three-part demographic information questionnaire, MMSQ moral sensitivity and Corelli's moral distress. The data were analyzed by statistical software and using independent t-test, Mann-Whitney, ANOVA, Spearman's correlation coefficient, chi-score. Results: The average moral sensitivity score of nurses was reported as 57.78 ± 13.53. The mean frequency of moral distress was 17.99 ± 37.01 and the intensity of moral distress was 52.83 ± 23.51. According to the classification, the frequency of moral distress is in the medium range and the intensity of moral distress is in the high range. In the examination of the relationship between sensitivity and repetition of moral distress among the subgroups of experiencing problems, the manner of interpersonal communication, independence and job sensitivity, a significant relationship was seen with repetition of moral distress. With the increase of these subgroups, the repetition of job distress also increases significantly. Ethical Considerations: This&nbsp; research&nbsp; has&nbsp; been&nbsp; approved&nbsp; by&nbsp; the&nbsp; ethics&nbsp; committee&nbsp; of Hamadan University of Medical Sciences (IR.UMSHA.REC.1399.090). After obtaining informed consent from the participants, the researcher assured them that all their information would be confidential. Conclusion: Considering the average level of ethical sensitivity of nurses, efforts should be made to improve and promote ethical issues in nursing. Various factors are involved in the level of moral sensitivity and moral distress of nurses in caring for patients. In this research, it was in a situation where the nurses were facing the peak of the Covid-19 pandemic and were under high organizational and psychological pressures. Therefore, for a better conclusion, it is suggested that this research be conducted with more samples and in the inpatient wards of affected patients and other departments. Keywords: moral sensitivity, moral distress, covid-19, nurse. &nbsp;زمینه و هدف: حساسیت اخلاقی پرستاران را قادر می‌سازد تا نیازهای مددجویانشان را تفسیر کرده و مطابق اصول اخلاقی به آن پاسخ دهند. پریشانی اخلاقی، پدیده شناخته‌شده‌ای در حرفه پرستاری است که می‌تواند استرس جسمی ـ روانی زیادی بر پرستاران وارد کند و باعث عدم رضایت آنان، کاهش کارایی و کیفیت مراقبت شود، لذا هر چقدر پرستاران حساسیت اخلاقی بالاتری داشته باشند، می‌تواند نقش مهمی در پیشگیری از شرایط ایجادکننده پریشانی اخلاقی داشته باشد، لذا مطالعه حاضر با هدف تعیین حساسیت اخلاقی و پریشانی اخلاقی در پرستاران مراقب بیماران مبتلا به Covid-19 در مراکز آموزشی درمانی وابسته به دانشگاه علوم پزشکی همدان انجام شد. روش: پژوهش حاضر یک مطالعه توصیفی ـ مقطعی است که بر روی 113 پرستار دانشگاه علوم پزشکی همدان در بازه زمانی فروردین تا تیرماه سال 1400 با روش نمونه‌گیری به صورت تصادفی طبقه‌بندی انجام شد. ابزار جمع‌آوری داده‌ها شامل پرسشنامه سه قسمتی اطلاعات دموگرافیک، حساسیت اخلاقی MMSQ و پریشانی اخلاقی کورلی جمع‌آوری گردید. داده‌ها توسط نرم‌افزار آماری SPSS 22 مورد تجزیه و تحلیل قرار گرفت. ملاحظات اخلاقی: پژوهشگر پس از اخذ رضایت آگاهانه از مشارکت‌کنندگان به آنان اطمینان داد که تمامی اطلاعاتشان محرمانه باقی خواهد ماند. یافته‌ها: در بررسی ارتباط بین حساسیت و تکرار پریشانی اخلاقی بین حساسیت اخلاقی (246/0, r=009/0p=)، (032/0, r=202/0p=)، زیرگروه‌های تجربه مشکلات (287/0, r=002/0p=)، نحوه ارتباطات بین فردی (024/0, r=202/0p=)، بهبود استقلال مددجو (246/0, r=009/0p=) با تکرار پریشانی اخلاقی ارتباط معنی‌داری دیده شد. با افزایش این زیرگروه‌ها تکرار پریشانی شغلی نیز طور معنی‌داری افزایش می‌یابد. میانگین نمره حساسیت اخلاقی پرستاران 53/13±78/57 در حد متوسط گزارش شد. میانگین تکرار پریشانی اخلاقی 99/17‌±‌01/37 و شدت پریشانی اخلاقی 51/23±83/52 بوده است. تکرار پریشانی اخلاقی در محدوده متوسط و شدت پریشانی اخلاقی در محدوده زیاد است. نتیجه‌گیری: با توجه به سطح حساسیت اخلاقی متوسط پرستاران، باید برای بهبود و ارتقای مسائل اخلاقی در پرستاری تلاش کرد. عوامل مختلفی در میزان حساسیت اخلاقی و پریشانی اخلاقی پرستاران در مراقبت از بیماران دخیل است. در این پژوهش در شرایطی بوده است که پرستاران با اوج پاندمی کووید-19 مواجه بوده‌اند و تحت فشارهای سازمانی و روانی بالایی قرار داشته‌اند

Effect of Mealtime During Hemodialysis on Patients’ Complications

Introduction: Food intake during hemodialysis increases the risk of problems such as hypotension, nausea, and vomiting in patients undergoing hemodialysis. This study aimed to determine the effect of mealtime during dialysis on the patients’ complications. Methods: This is a quasi-experimental study consisted of all eligible hemodialysis patients in Hamadan teaching hospitals. All of 48 patients were selected through census method. The research was conducted in two sessions. At both sessions, patients were kept fasting prior to hemodialysis. In the first session, after one hour and in the second session after two hours of hemodialysis, a meal containing 350 kcal of energy was given to the patients. Blood pressure and intensity of nausea and vomiting was measured and recorded immediately before the start of hemodialysis, and then every half an hour before the termination of the hemodialysis. Results: The results showed that in both sessions, food intake caused a drop in the systolic and diastolic blood pressure, but changes in the mealtime had no effect on the systolic and diastolic blood pressure. Also, statistical test showed that changes in the mealtime had no significant impact on the intensity of nausea and vomiting. Conclusion: Food intake during hemodialysis had no effect on the nausea and vomiting, but caused a drop in the systolic and diastolic blood pressure, the drop continued for one hour and one and a half hour after the meal. It is suggested, mealtime in the early hours of hemodialysis could be better managed during the hemodialysis process

The landscape of circRNAs in gliomas temozolomide resistance: Insights into molecular pathways

As the deadliest type of primary brain tumor, gliomas represent a significant worldwide health concern. Circular RNA (circRNA), a unique non-coding RNA molecule, seems to be one of the most alluring target molecules involved in the pathophysiology of many kinds of cancers. CircRNAs have been identified as prospective targets and biomarkers for the diagnosis and treatment of numerous disorders, particularly malignancies. Recent research has established a clinical link between temozolomide (TMZ) resistance and certain circRNA dysregulations in glioma tumors. CircRNAs may play a therapeutic role in controlling or overcoming TMZ resistance in gliomas and may provide guidance for a novel kind of individualized glioma therapy. To address the biological characteristics of circRNAs and their potential to induce resistance to TMZ, this review has highlighted and summarized the possible roles that circRNAs may play in molecular pathways of drug resistance, including the Ras/Raf/ERK PI3K/Akt signaling pathway and metabolic processes in gliomas

The value of ovarian hyperstimulation syndrome in predicting pregnancy outcome in women with polycystic ovarian syndrome and candidate for in vitro fertilization: A case-control study

Abstract Background: Ovarian hyperstimulation syndrome (OHSS) as a known complication in women with polycystic ovarian syndrome (PCOS) may occur following inducible fertility treatments such as in vitro fertilization (IVF) and can affect the sequels of these treatments. Objective: This study aimed to assess the effects of OHSS on pregnancy outcomes through IVF in women with PCOS. Also, we assessed the value of baseline sexual hormones to predict the pregnancy's success. Materials and Methods: This case-control study was conducted on 180 consecutive women suffering from PCOS who were candidates for IVF at Fatemieh hospital in Hamadan, Iran, from May-July 2022. The women were assigned to the case group (with OHSS, n = 129) and the control group (without OHSS, n = 51). Measuring the sexual hormones was performed using the enzyme-linked immunosorbent technique. Results: In the multivariable logistic regression model, OHSS could not predict the likelihood of clinical or chemical pregnancy following IVF. None of the baseline sexual hormones could predict the successful chemical or clinical pregnancy in PCOS women following IVF. Conclusion: OHSS may not influence IVF-related outcomes in PCOS women. The values of sexual hormones may not also determine the pointed outcome

Report of Intracerebral Hemorrhage Following Myocardial Infarction

Background and Objectives: Stroke is a rare complication of myocardial infarction (AMI). Aspirin, plavix, and enoxaparin are among drug treatments for myocardial infarction, which lead to stroke. The present study is a case report of stroke after myocardial infarction, which discusses patient&rsquo;s records and clinical history along with paraclinical findings. Case Report: The patient was a 60-year-old man with a history of heart disease and diabetes, presented with severe chest pain and dyspnea to the Emergency Department of Yasuj Sajad Hospital on January 29, 2015, and after taking ECG, it was found that there was no signs of myocardial infarction, but troponin test was positive two times. The diagnosis was myocardial infarction without ST segment elevation. The patient took aspirin and plavix, and after subcutaneous injection of enoxaparin at the dose of 80 mg, his level of consciousness decreased, which caused GCS:5, right-side mydriasis, and motor paralysis in the left half of the body, therefore, CT was performed, and the patient that had about 90 ml hemorrhage in temporoparietal lobe. The patient was transformed to the operating room and 60 ml blood was removed using partial lobectomy and a microscope. After hospitalization in ICU for several days, the patient was extubated under the SIMV mode. Considering the high prevalence of heart disease, especially increasing rate of myocardial infarction in the country, anticoagulants should be more carefully used and after administration of this group of drugs, patients be regularly monitored for side effects