Role of splenectomy in human liver transplantation under modern-day immunosuppression

Between January 1987 and October 1991, 1466 patients underwent consecutive Orthotopic Liver Transplantation (OLTx) at the University of Pittsburgh. Forty of these patient's had concomitant splenectomy with OLTx. These patients were compared to 147 randomly selected OLTx patients without splenectomy within the same time period. One-year patient and graft survival (PS and GS) were lower in splenectomized (Splx) patients compared to nonsplenectomized (non-Splx) patients (59% vs 86% PS, 55% vs 80% GS, respectively). One-month and one-year patient mortality in the Splx group was higher than in the non-splx patients (20% vs 3.4% P < 0.001 for one month; 40% vs 14.3%, P = 0.003 for one year, respectively). One-month and one-year sepsis-related mortality was also high in Splx patients (17.5% vs 2.7%, P = 0.0022, for one month, and 30% vs 11.5%, P = 0.0043, for one year, respectively). We conclude that concomitant splenectomy with OLTx has a significantly higher patient mortality mainly due to its septic complications and, at present, unless there is a specific indication for a splenectomy, the routine addition of this procedure to liver allograft surgery would not be recommended

Effective Compton Cross Section in Non-Degenerate High Temperature Media

The effective compton cross section in a non-degenerate plasma($n\ll\{\frac{(kT/c)^{2}+2mkT}{h^{2}}\}^{^{3/2}}$) is investigated in a wide range of temperatures. The results show a decreasing behavior with temperature especially for $kT\gg m_{e}c^{2}$. The $may be important in phenomena like accretion discs or ultra-relativistic blast waves in GRB models, where the emitted radiation has to pass through a medium containing high energy electrons.Comment: 12 pages, 7 figure

A Study on anisotropy of cosmic ray distribution with a small array of water-cherenkov detectors

The study of the anisotropy of the arrival directions is an essential tool to investigate the origin and propagation of cosmic rays primaries. A simple way of recording many cosmic rays is to record coincidences between a number of detectors. We have monitored multi-TeV cosmic rays by a small array of water cherenkov detectors in Tehran(35 43 N, 51 20 E, 1200m a.s.l). More than 1.1*10^6 extensive air shower events were recorded. In addition to the Compton- Getting effect due to the motion of the earth in the Galaxy, an anisotropy has been observed which is due to a unidirectional anisotropy of cosmic ray flow along the Galactic arms.Comment: 16 pages 9 figs and one tabl

Concepts and Dimensions in Continuous Midwifery Care Models Based on the Experiences and Expectations of Stakeholders: A Meta-Synthesis

Context: Pregnant women’s have access to different models of care especially to those who provide continuous care and this is one of the recommendations of the world health organization (WHO) for promoting maternal health. Moreover, to provide adequate services in care models, the experiences and perceptions of mothers, providers of prenatal care, and other stakeholders should be taken into consideration. Objectives: A systematic meta-synthesis was carried out to inquire into the findings of some qualitative studies aimed to explore the concept and dimensions of continuous midwifery care including experiences, perspectives and perceptions of engaged people. Data Sources: This study was the first step of an action research designed to develop a midwifery model of care. Qualitative research articles published between 2005 and 2015 on experiences, attitudes, expectations and opinions of stakeholders in models of midwifery care were collected from Google scholar, Elsevier, and PubMed databases. Study Selection: Following the various stages of the scrutiny of the abstracts and contents of the collected articles, five faculty members finally selected 21 qualitative research articles as eligible for inclusion in the meta-synthesis. Results: The findings of meta-synthesis showed that continuous midwifery care for pregnantwomenas a highly important process revolves around at least five basic themes: continuity of care, compliance with needs satisfaction levels, regulation of care environment, and the philosophy of providing continuous care. Conclusions: Given the importance of access to healthcare as a right for pregnant women and given the key role of continuous midwifery care in health promotion and maternal satisfaction, it is suggested based on the results of the study that rigorous local and national research in this area to be carried out so that adequate models of continuous midwifery care can be designed and implemented based on the findings

Effects of Selenium Supplementation on Gene Expression Levels of Inflammatory Cytokines and Vascular Endothelial Growth Factor in Patients with Gestational Diabetes

Selenium is known to exert multiple beneficial effects including anti-inflammatory actions. The aim of the study was to evaluate the effects of selenium supplementation on gene expression levels of inflammatory cytokines and vascular endothelial growth factor (VEGF) in women with gestational diabetes (GDM). This randomized double-blind, placebo-controlled trial was carried out among 40 subjects diagnosed with GDM aged 18–40 years old. Subjects were randomly allocated into two groups to receive either 200 μg/day selenium supplements (n = 20) or placebo (n = 20) for 6 weeks. Gene expression of inflammatory cytokines and VEGF were assessed in lymphocytes of GDM women with RT-PCR method. Results of RT-PCR indicated that after the 6-week intervention, compared with the placebo, selenium supplementation downregulated gene expression of tumor necrosis factor alpha (TNF-α) (P = 0.02) and transforming growth factor beta (TGF-β) (P = 0.01), and upregulated gene expression of VEGF (P = 0.03) in lymphocytes of patients with GDM. There was no statistically significant change following supplementation with selenium on gene expression of interleukin (IL)-1β and IL-8 in lymphocytes of subjects with GDM. Selenium supplementation for 6 weeks in women with GDM significantly decreased gene expression of TNF-α and TGF-β, and significantly increased gene expression of VEGF, but did not affect gene expression of IL-1β and IL-8

Effect of Structure on Strength of Agglomerates using Distinct Element Method

Knowledge of agglomerate strength is highly desirable for compression and tableting, dissolution and dispersion and mitigation of dust formation. The behaviour of agglomerates is affected by parameters such as density, agglomerate size, primary particle size, and interparticle bond strength. The method of agglomeration influences the evolution of structure, and this in turn affects its strength. Furthermore, the methods of strength characterisation, i.e. quasi-static or impact produce different results. To understand the role of structure and the influence of test method, agglomerate failure behaviour has been analysed by the use of the Distinct Element Method (DEM). We report on our work on the simulation of the breakage of the agglomerates for different porosities and impact conditions, where the role of impact speed and angle and type of contact bonding model have been evaluated. The adhesive contact model of JKR is used to form an agglomerate. The effect of the bonding level on the strength and size distribution of the clusters released as a result of failure has been investigated. This work also evaluates the effect of structure (porosity) on the strength of the agglomerates

The influences of vitamin D and omega-3 co-supplementation on clinical, metabolic and genetic parameters in women with polycystic ovary syndrome

Objective: The aim of this study was to evaluate the effect of the co-administration of vitamin D and omega-3fatty acid on clinical, metabolic and genetic parameters in women with polycystic ovary syndrome (PCOS). Methods: This randomized, double-blinded, placebo-controlled clinical trial was conducted on 60 subjects, aged 18–40 years old with PCOS. Subjects were randomly allocated to take either 50,000 IU vitamin D every 2 weeks plus 2000 mg/day omega-3 fatty acid from fish oil (n=30) or placebo (n=30) for 12 weeks. Gene expression analysis of inflammatory cytokines was conducted on peripheral blood mononuclear cells (PBMCs) of PCOS women using RT-PCR method. Results: Vitamin D and omega -3 fatty acid co-supplementation significantly decreased serum total testosterone levels (−0.2 ± 0.5 vs.+0.1 ± 0.4 ng/mL, P=0.02) compared with the placebo. In addition, vitamin D and omega-3 fatty acid co-supplementation resulted in a significant improvement in beck depression inventory (−1.4 ± 1.6 vs. −0.5 ± 0.6, P=0.01), general health questionnaire scores (−4.5 ± 4.3 vs. −1.9 ± 2.3, P=0.005) and depression anxiety and stress scale scores (−5.0 ± 5.1 vs. −2.3 ± 3.5, P=0.01) compared with the placebo. Additionally, vitamin D and omega-3 fatty acid co-administration significantly decreased serum high-sensitivity C-reactive protein (hs-CRP) (−1.2 ± 1.9 vs.+0.1 ± 0.7 mg/L, P=0.001) and malondialdehyde (MDA) levels (−0.4 ± 0.4 vs.+0.2 ± 0.6 μmol/L, P<0.001), and significantly increased plasma total antioxidant capacity (TAC) levels (+ 114.6 ± 122.2 vs. -2.4 ± 168.2 mmol/L, P=0.003) compared with the placebo. Results of RT-PCR demonstrated that vitamin D and omega-3 fatty acid co-supplementation significantly downregulated gene expression of interleukin-1 (IL-1) (P=0.03), and upregulated vascular endothelial growth factor (VEGF) (P=0.004) in PBMCs of subjects with PCOS, when compared with placebo. Conclusions: Overall, the co-administration of vitamin D and omega-3 fatty acid for 12 weeks had beneficial effects on mental health parameters, serum total testosterone, hs-CRP, plasma TAC and MDA levels, and gene expression of IL-1 and VEGF among women with PCOS