ABSTRACT
Purpose@#Improving physicians’ critical thinking abilities could have meaningful impacts on various aspects of routine medical practice, such as choosing treatment plans, making an accurate diagnosis, and reducing medical errors. The present study aimed to measure the effects of a curriculum integrating critical thinking on medical students’ skills at Tehran University of Medical Sciences, Iran. @*Methods@#A 1-group pre-test, post-test quasi-experimental design was used to assess medical students’ critical thinking abilities as they progressed from the first week of medical school to middle of the third year of the undergraduate medical curriculum. Fifty-six participants completed the California Critical Thinking Skills Test twice from 2016 to 2019. @*Results@#Medical students were asked to complete the California Critical Thinking Skills Test the week before their first educational session. The post-test was conducted 6 weeks after the 2 and half-year program. Out of 91 medical students with a mean age of 20±2.8 years who initially participated in the study, 56 completed both the pre- and post-tests. The response rate of this study was 61.5%. The analysis subscale showed the largest change. Significant changes were found in the analysis (P=0.03), evaluation (P=0.04), and inductive reasoning (P<0.0001) subscales, but not in the inference (P=0.28), and deductive reasoning (P=0.42) subscales. There was no significant difference according to gender (P=0.77). @*Conclusion@#The findings of this study show that a critical thinking program had a substantial effect on medical students’ analysis, inductive reasoning, and evaluation skills, but negligible effects on their inference and deductive reasoning scores.
ABSTRACT
Purpose@#Improving physicians’ critical thinking abilities could have meaningful impacts on various aspects of routine medical practice, such as choosing treatment plans, making an accurate diagnosis, and reducing medical errors. The present study aimed to measure the effects of a curriculum integrating critical thinking on medical students’ skills at Tehran University of Medical Sciences, Iran. @*Methods@#A 1-group pre-test, post-test quasi-experimental design was used to assess medical students’ critical thinking abilities as they progressed from the first week of medical school to middle of the third year of the undergraduate medical curriculum. Fifty-six participants completed the California Critical Thinking Skills Test twice from 2016 to 2019. @*Results@#Medical students were asked to complete the California Critical Thinking Skills Test the week before their first educational session. The post-test was conducted 6 weeks after the 2 and half-year program. Out of 91 medical students with a mean age of 20±2.8 years who initially participated in the study, 56 completed both the pre- and post-tests. The response rate of this study was 61.5%. The analysis subscale showed the largest change. Significant changes were found in the analysis (P=0.03), evaluation (P=0.04), and inductive reasoning (P<0.0001) subscales, but not in the inference (P=0.28), and deductive reasoning (P=0.42) subscales. There was no significant difference according to gender (P=0.77). @*Conclusion@#The findings of this study show that a critical thinking program had a substantial effect on medical students’ analysis, inductive reasoning, and evaluation skills, but negligible effects on their inference and deductive reasoning scores.
ABSTRACT
Background: preeclampsia [PE] is a serious complication of pregnancy with hallmarks of incomplete placentation, placental ischemia and endothelial dysfunction. Imbalance between vascular endothelial growth factor [VEGF], placenta growth factor [PlGF] and their receptors play important role in pathophysiology of PE
Objective: this study was aimed to asses PlGF mRNA expression in placenta of women affected with PE
Material and Methods: in this cross-sectional study, expression of PlGF mRNA was evaluated in 26 mild PE cases, 15 severe preeclamptic women and 20 normotensive controls. Patients were sub-classified as early onset PE [9] and late onset [32]. After RNA extraction, PlGF expression was quantified with qRT-PCR
Results: the results of PlGF mRNA expression between mild-severe, and early-late onset PE patients showed no statistically significant difference compared with the control group [p=0.661, p=0.205 respectively]
Conclusion: despite we found no distinct differential expression of PlGF mRNA in placental tissue of PE patients compared with control women, but according to decreased level of this angiogenic factor in PE even before clinical onset of the disease, determining molecular mechanisms related to reduced secretion of PlGF into the maternal circulation may be useful for future therapeutics
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Background: Genetic and environmental factors are both involved in the etiology of Non-Alcoholic Fatty Liver Disease [NAFLD]. Among the genetic factors, certain polymorphisms of adiponectin gene are associated with NAFLD. In the current study, we investigated the association between metabolic parameters with different genotypes of adiponectin +276 G>T polymorphism among the Iranian NAFLD patients, and the effect of nutritional intake with development of NAFLD
Methods: In this study, 75 patients with NAFLD and 76 healthy individuals were enrolled. Dietary intakes were assessed using a semi- quantitative Food-Frequency Questionnaire [FFQ]. Body Mass Index [BMI] and Waist to Hip Ratio [WHR] were calculated. Biochemical assays including FSG [Fasting Serum Glucose], liver enzymes, lipid profiles, Malondialdehyde, insulin resistance and Total Antioxidant Capacity [TAC] were measured after 12 hr fasting. Gene polymorphism study was done by using of sequencing method
Results: Although, T allele frequency was more prevalent in patients with NAFLD than control, adiponectin +276 G>T polymorphism was not associated with risk of NAFLD. Among the metabolic parameters, TAC in TT genotype was significantly lower 1.44[0.69 to 2.81] p>0.05, AST in GT, GG genotypes, and ALT in all three genotypes were higher in NAFLD patients in compared to healthy subjects [p<0.05]. Patients with GT genotype have significantly lower fat consumption and vitamin E intake as compared to control group with the same genotype [p<0.05]
Conclusion: In this study, we showed the association of different genotypes of +276 G>T polymorphism in adiponectin gene with some metabolic parameters
ABSTRACT
Objective: Nonunion is defined as a minimum of a 9-month period of time since an injury with no visibly progressive signs of healing for 3 months. Recent studies show that application of mesenchymal stromal cells [MSCs] in the laboratory setting is effective for bone regeneration. Animal studies have shown that MSCs can be used to treat nonunions. For the first time in an Iranian population, the present study investigated the safety of MSC implantation to treat human lower limb long bone nonunion
Materials and Methods: It is a prospective clinical trial for evaluating the safety of using autologus bone marrow derived mesenchymal stromal cells for treating nonunion. Orthopedic surgeons evaluated 12 patients with lower limb long bone nonunion for participation in this study. From these, 5 complied with the eligibility criteria and received MSCs. Under fluoroscopic guidance, patients received a one-time implantation of 20-50x106 MSCs into the nonunion site. All patients were followed by anterior-posterior and lateral X-rays from the affected limb, in addition to hematological, biochemical, and serological laboratory tests obtained before and 1, 3, 6, and 12 months after the implantation. Possible adverse effects that included local or systemic, serious or non-serious, and related or unrelated effects were recorded during this time period
Results: From a safety perspective, all patients tolerated the MSCs implantation during the 12 months of the trial. Three patients had evidence of bony union based on the after implantation X- rays
Conclusion: The results have suggested that implantation of bone marrow-derived MSCs is a safe treatment for nonunion. A double-blind, controlled clinical trial is required to assess the efficacy of this treatment
Subject(s)
Adult , Adolescent , Female , Humans , Male , Middle Aged , Young Adult , Autografts , Transplantation, Autologous/methods , Plastic Surgery Procedures , Mesenchymal Stem Cells , Lower Extremity , Prospective StudiesABSTRACT
Background: The use of biomarkers for diagnosis of Preeclampsia [PE], a life-threatening pregnancy disorder, could reduce serious complications of this disease. In this study, we investigated dysregulation of endoglin [Eng] expression and diagnostic accuracy of soluble endoglin [sEng] in PE patients
Methods: For this case-control study, 26 mild and 15 severe preeclamptic women along with 20 normotensive controls were recruited. The expression level of Eng [the co-receptor of TGF-[31] was evaluated using qRT-PCR
Also, the serum concentration of soluble Eng and expression of membranous Eng were determined by ELISA and immunohistochemistry
Results: A significant up-regulation in Eng mRNA and sEng levels was observed in PE patients versus normal controls. Immunohistochemistry [IHC] showed up-regulation of membranous Eng staining in syncytiotrophoblast and cytotrophoblast cells of PE patients
The serum levels of sEng were significantly increased in all patients [mild, sever, early- and late-onset] as compared to healthy pregnant women [P<0.001]. Receiver-operating characteristic [ROC] curve analysis revealed that sEng had the highest accuracy in distinguishing PE from normal pregnancies with cut-off value of 20.4, sensitivity of 92.1%, specificity of 90%, and area under the curve [AUC] of 0.94 [95% Cl: 0.88-1.00]
Conclusions: Our data showed that the up-regulation of Eng mRNA along with its membranous and soluble form in PE patients leads to defect in angiogenesis pathway. Also, the results of this study revealed sEng potential as a marker for diagnosis of PE and its severity
Subject(s)
Humans , Women , Young Adult , Adult , Endoglin , Biomarkers , Pregnancy Complications , Pregnant Women , RNA, Messenger , Case-Control Studies , IranABSTRACT
Objective: nonunion is defined as a minimum of 9 months since injury without any visible progressive signs of healing for 3 months. Recent literature has shown that the application of mesenchymal stromal cells is safe, in vitro and in vivo, for treating long bone nonunion. The present study was performed to investigate the safety of mesenchymal stromal cell [MSC] implantation in combination with platelet lysate [PL] product for treating human long bone nonunion
Materials and Methods: in this case series clinical trial, orthopedic surgeons visited eighteen patients with long bone nonunion, of whom 7 complied with the eligibility criteria. These patients received mesenchymal stromal cells [20 million cells implanted once into the nonunion site using a fluoroscopic guide] in combination with PL product. For evaluation of the effects of this intervention all the patients were followed up by taking anterior-posterior and lateral X-rays of the affected limb before and 1, 3, 6, and 12 months after the implantation. All side effects [local or systemic, serious or non-serious, related or unrelated] were observed during this time period
Results: from a safety perspective the MSC implantation in combination with PL was very well tolerated during the 12 months of the trial. Four patients were healed; based on the control X- ray evidence, bony union had occurred
Conclusion: results from the present study suggest that the implantation of bone marrow-derived MSCs in combination with PL is safe for the treatment of nonunion. A double blind, controlled clinical trial is required to assess the efficacy of this treatment [Registration Number: NCT01206179]