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Abstract Objectives: Remdesivir is an antiviral agent with positive effects on the prognosis of Coronavirus Disease (COVID-19). However, there are concerns about the detrimental effects of remdesivir on kidney function which might consequently lead to Acute Kidney Injury (AKI). In this study, we aim to determine whether remdesivir use in COVID-19 patients increases the risk of AKI. Methods: PubMed, Scopus, Web of Science, the Cochrane Central Register of Controlled Trials, medRxiv, and bio-Rxiv were systematically searched until July 2022, to find Randomized Clinical Trials (RCT) that evaluated remdesivir for its effect on COVID-19 and provided information on AKI events. A random-effects model metaanalysis was conducted and the certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation. The primary outcomes were AKI as a Serious Adverse Event (SAE) and combined serious and non-serious Adverse Events (AE) due to AKI. Results: This study included 5 RCTs involving 3095 patients. Remdesivir treatment was not associated with a significant change in the risk of AKI classified as SAE (Risk Ratio [RR]: 0.71, 95% Confidence Interval [95% CI] 0.43‒1.18, p = 0.19, low-certainty evidence) and AKI classified as any grade AEs (RR = 0.83, 95% CI 0.52‒1.33, p = 0.44, low-certainty evidence), compared to the control group. Conclusion: Our study suggested that remdesivir treatment probably has little or no effect on the risk of AKI in COVID-19 patients.
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Matrix metalloproteinase-9 (MMP-9) is a zinc and calcium-dependent proteolytic enzyme involved in extracellular matrix degradation. Overexpression of MMP-9 has been confirmed in several disorders, including cancers, Alzheimer′s disease, autoimmune diseases, cardiovascular diseases, and dental caries. Therefore, MMP-9 inhibition is recommended as a therapeutic strategy for combating various diseases. Cinnamic acid derivatives have shown therapeutic effects in different cancers, Alzheimer′s disease, cardiovascular diseases, and dental caries. A computational drug discovery approach was performed to evaluate the binding affinity of selected cinnamic acid derivatives to the MMP-9 active site. The stability of docked poses for top-ranked compounds was also examined. Twelve herbal cinnamic acid derivatives were tested for possible MMP-9 inhibition using the AutoDock 4.0 tool. The stability of the docked poses for the most potent MMP-9 inhibitors was assessed by molecular dynamics (MD) in 10 nanosecond simulations. Interactions between the best MMP-9 inhibitors in this study and residues incorporated in the MMP-9 active site were studied before and after MD simulations. Cynarin, chlorogenic acid, and rosmarinic acid revealed a considerable binding affinity to the MMP-9 catalytic domain (ΔGbinding < –10 kcal/ mol). The inhibition constant value for cynarin and chlorogenic acid were calculated at the picomolar scale and assigned as the most potent MMP-9 inhibitor from the cinnamic acid derivatives. The root-mean-square deviations for cynarin and chlorogenic acid were below 2 Å in the 10 ns simulation. Cynarin, chlorogenic acid, and rosmarinic acid might be considered drug candidates for MMP-9 inhibition.
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Purpose@#Investigations of the hemodynamic changes of the venous system in patients with multiple sclerosis (MS) have shown contradictory results. Herein, the biomechanical parameters of the internal jugular vein (IJV) and common carotid artery (CCA) of MS patients were extracted and compared to healthy individuals. @*Methods@#B-mode and Doppler sequential ultrasound images of 64 IJVs and CCAs of women including 22 healthy individuals, 22 relapsing-remitting multiple sclerosis (RRMS) patients, and 20 primary-progressive multiple sclerosis (PPMS) patients were recorded and processed. The biomechanical parameters of the IJV and the CCA walls during three cardiac cycles were calculated. @*Results@#The IJV maximum and minimum pressures were higher in the MS patients than in the healthy subjects, by 31% and 19% in RRMS patients and 39% and 24% in PPMS patients. The venous wall thicknesses in RRMS and PPMS patients were 51% and 60% higher than in healthy subjects, respectively. IJV distensibility in RRMS and PPMS patients was 70% and 75% lower, and compliance was 40% and 59% lower than in healthy subjects. The maximum intima-media thicknesses of the CCAs were 38% and 24%, and the minimum intima-media thicknesses were 27% and 23% higher in RRMS and PPMS patients than in healthy individuals, respectively. The shear modulus of CCA walls in RRMS and PPMS patients was 17% and 31%, and the radial elastic moduli were 47% and 9% higher than in healthy individuals. @*Conclusion@#Some physical and biomechanical parameters of the CCA and IJV showed significant differences between MS patients and healthy individuals.
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Kaiy (medieval cautery) is an ancient method of heat therapy in traditional Persian medicine (TPM). Some of its important applications have been neglected during the medical revolution. Meanwhile, different treatment modalities that incorporate heat, including moxibustion, have progressed in traditional Chinese medicine. In this study, we reviewed the main TPM textbooks that were written specifically in the field of kaiy. We considered the traditional teachings in the context of contemporary information, gathered from the scientific literature about moxibustion and modern cauterization. Some surgical therapeutic indications of kaiy (e.g., debridement and coagulative procedures) have been advanced by the innovation of electro-cauterization. However, those therapeutic applications that were based on the TPM humoral theory for relieving body coldness or myofascial pains-which are similar to moxibustion usages-have not received the same attention. Apart from the broad similarities of kaiy and moxibustion as thermal therapies with similar indications, there is a striking correspondence between kaiy point mapping and acupoints. Therefore, further research on different kaiy aspects is recommended. Please cite this article as: Jaladat AM, Alizadeh Vaghasloo M, Atarzadeh F, Ayati MH, Kazemi AH, Akin E, Hashempur MH. Similarities and differences between kaiy in Persian medicine and moxibustion in Chinese medicine. J Integr Med. 2023; 21(4):354-360.
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Moxibustion/history , Acupuncture Therapy , Medicine, Chinese Traditional , Acupuncture Points , Medicine, TraditionalABSTRACT
Stroke in children is a rare but devastating disease. Although endovascular treatment has been reported to be safe and effective in the treatment of stroke with large vessel occlusion in this population, there are still limitations and controversies. In this case report, we describe a 12-month-old girl who was admitted to the hospital with acute onset of left-sided hemiplegia and confusion, which turned out to be due to a large infarct in the right middle cerebral artery territory, possibly caused by dissection of the right cervical internal carotid artery. Aspiration thrombectomy was successfully performed, and the patient was able to walk a few steps and raise her left upper extremity at the 12-month follow-up. The aspiration-only technique in thrombectomy may be safe and technically feasible to treat acute ischemic stroke with large vessel occlusion in children as young as 12 months, although large-volume prospective studies are needed.
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New findings in regenerative medicine have always been combined with numerous animal studies. Therefore, choos‑ ing the right translational animal model plays an important role in transferring as much basic knowledge as possible to clinical application in this field. Since microsurgery has many capabilities to perform precise interventions on small animal models and facilitates other regenerative medicine procedures, based on scientific articles, we believe that the key to the flourishing of regenerative medicine in the clinic is the use of microsurgery.
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This study aimed to identify the indices/indicators used for evaluating the “creating supportive environments” mechanism of the Ottawa Charter for Health Promotion, with a focus on built environments, in different settings. A search for literature with no time limit constraint was performed across Medline (via PubMed), Scopus, and Embase databases. Search terms included “Ottawa Charter,” “health promotion,” “supportive environments,” “built environments,” “index,” and “indicator.” we included the studies conducted on developing, identifying, and/or measuring health promotion indices/indicators associated with “built environments” in different settings. The review articles were excluded. Extracted data included the type of instrument used for measuring the index/indicator, the number of items, participants, settings, the purpose of indices/indicators, and a minimum of two associated examples of the indices domains/indicators. The key definitions and summarized information from studies are presented in tables. In total, 281 studies were included in the review, within which 36 indices/indicators associated with “built environment” were identified. The majority of the studies (77%) were performed in developed countries. Based on their application in different settings, the indices/indicators were categorized into seven groups: (1) Healthy Cities (n=5), (2) Healthy Municipalities and Communities (n=18), (3) Healthy Markets (n=3), (4) Healthy Villages (n=1), (5) Healthy Workplaces (n=4), (6) Health-Promoting Schools (n=3), and (7) Healthy Hospitals (n=3). Health promotion specialists, health policymakers, and social health researchers can use this collection of indices/indicators while designing/evaluating interventions to create supportive environments for health in various settings.
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Background@#Since prediabetes is a risk factor for metabolic syndromes, it is important to promote a healthy lifestyle to prevent prediabetes. This study aimed to determine the effects of green coffee (GC), chlorogenic acid (CGA) intake, and exercise training (EX) on hepatic lipid metabolism in prediabetes male C57BL/6 mice. @*Methods@#Forty-nine mice were randomly divided into two groups feeding with a normal diet (n=7) or a high-fat diet (HFD, n=42) for 12 weeks. Then, HFD mice were further divided into six groups (n=7/group): control (pre-D), GC, CGA, EX, GC+EX, and CGA+EX. After additional 10 weeks under the same diet, plasma, and liver samples were obtained. @*Results@#HFD-induced prediabetes conditions with increases in body weight, glucose, insulin, insulin resistance, and lipid profiles were alleviated in all treatment groups. Acsl3, a candidate gene identified through an in silico approach, was lowered in the pre-D group, while treatments partly restored it. HFD induced adverse alterations of de novo lipogenesis- and β oxidation-associated molecules in the liver. However, GC and CGA supplementation and EX reversed or ameliorated these changes. In most cases, GC or CGA supplementation combined with EX has no synergistic effect and the GC group had similar results to the CGA group. @*Conclusion@#These findings suggest that regular exercise is an effective non-therapeutic approach for prediabetes, and CGA supplementation could be an alternative to partially mimic the beneficial effects of exercise on prediabetes.
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Abstract Objective The study aimed to compare the response of human dental pulp stem cells (hDPSCs) towards three hydraulic calcium silicate cements (HCSCs) by measuring cytotoxicity and expression of dentinogenic genes. Methodology Dental pulps of five impacted mandibular third molars were extirpated as a source for hDPSCs. Next to culturing, hDPSCs were subjected to fluorescence-activated cell sorting after the third passage to validate stemness of the cells. Human DPSCs were exposed to diluted supernatants of OrthoMTA (OMTA), Biodentine (BD) and Calcium-Enriched Mixture (CEM) at concentrations 10, 25, 50 and 100% at the first, third and fifth day of culture. Then, cells were exposed to 10% concentrations supernatant of HCSCs to determine DSPP and DMP1 gene expression, using a quantitative polymerase-chain reaction. Data were analyzed using one-way and three-way ANOVA, followed by Tukey post hoc statistical tests. Results Optimal cell proliferation was observed in all groups, regardless of concentration and time-point. HCSC supernatants were non-cytotoxic to hDPSCs at all three time-points, except for 100% Biodentine on day five. On day seven, OMTA group significantly upregulated the expression of DSPP and DMP1 genes. On day 14, expression of DMP1 and DSPP genes were significantly higher in BD and OMTA groups, respectively. Conclusion Biodentine significantly upregulated DMP1 gene expression over 14 days, whereas CEM was associated with only minimal expression of DSPP and DMP1 .
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Abstract Hypoxia-inducible factors (HIFs) and cancer stem cells (CSCs) are two challenging causes of radiotherapy and chemotherapy resistance, leading to most cases of failure and recurrence in breast cancer therapy. This study was conducted to investigated the inhibitory effect of combination therapy with doxorubicin (an anthracycline) and FM19G11 (an HIF inhibitor) on MCF-7 cells and their CSC-like cells (CSC-LCs). MCF-7 CSC-LCs with a CD44+/CD24- phenotype were sorted and characterized by flow cytometry. A combination of doxorubicin and FM19G11 caused more cytotoxic effects on MCF-7 and CSC-LCs compared to doxorubicin monotherapy. The largest synergistic effect was observed in CSC-LCs under hypoxic conditions; however, MCF-7 cells showed no synergism in normoxic conditions. The administration of doxorubicin and FM19G11 induced late apoptotic and necrotic cell death in MCF-7 and CSC-LCs. Additionally, G2 phase arrest was observed in both cells. Our results demonstrated that co-administration of FM19G11 and doxorubicin had a synergistic effect in hypoxia and improved drug resistance in breast cancer stem cells.
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Purpose@#Screening serologic tests are important tools for the diagnosis of celiac disease (CD). Immunoglobulin (Ig)G anti-deamidated gliadin peptide (anti-DGP) is a relatively new autoantibody thought to have good diagnostic accuracy, comparable to that of anti-tissue transglutaminase (anti-tTG) antibody. @*Methods@#Pediatric patients (n=86) with a clinical suspicion of CD were included. Duodenal biopsy, anti-tTG, and IgG anti-DGP antibody tests were performed. The patients were divided into CD and control groups based on the pathological evaluation of duodenal biopsies. The diagnostic accuracy of serological tests was determined. @*Results@#IgA anti-tTG and IgG anti-DGP antibodies were positive in 86.3% and 95.4% of patients, respectively. The sensitivity, specificity, and diagnostic accuracy of the IgA anti-tTG test were 86.3%, 50.0%, and 68.6%, respectively, and those of the IgG anti-DGP test were 95.4%, 85.7%, and 90.7%, respectively. The area under the receiver operating characteristic (ROC) curve was 0.84 (95% confidence interval [CI], 0.74–0.91) for IgA anti-tTG test and 0.93 (95% CI, 0.86–0.97) for IgG anti-DGP test. The comparison of IgA anti-tTG and IgG anti-DGP ROC curves showed a higher sensitivity and specificity of the IgG anti-DGP test. @*Conclusion@#IgG anti-DGP is a reliable serological test for CD diagnosis in children. High tTG and DGP titers in the serum are suggestive of severe duodenal atrophy. The combined use of IgA anti-tTG and IgG anti-DGP tests for the initial screening of CD can improve diagnostic sensitivity.
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Objective@#This study aimed to present and evaluate a new deep learning model for determining cervical vertebral maturation (CVM) degree and growth spurts by analyzing lateral cephalometric radiographs. @*Methods@#The study sample included 890 cephalograms. The images were classified into six cervical stages independently by two orthodontists. The images were also categorized into three degrees on the basis of the growth spurt: pre-pubertal, growth spurt, and post-pubertal. Subsequently, the samples were fed to a transfer learning model implemented using the Python programming language and PyTorch library. In the last step, the test set of cephalograms was randomly coded and provided to two new orthodontists in order to compare their diagnosis to the artificial intelligence (AI) model’s performance using weighted kappa and Cohen’s kappa statistical analyses. @*Results@#The model’s validation and test accuracy for the six-class CVM diagnosis were 62.63% and 61.62%, respectively. Moreover, the model’s validation and test accuracy for the three-class classification were 75.76% and 82.83%, respectively. Furthermore, substantial agreements were observed between the two orthodontists as well as one of them and the AI model. @*Conclusions@#The newly developed AI model had reasonable accuracy in detecting the CVM stage and high reliability in detecting the pubertal stage. However, its accuracy was still less than that of human observers. With further improvements in data quality, this model should be able to provide practical assistance to practicing dentists in the future.
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In September 2017, an outbreak with high mortality, which showed the typical signs of ND, occurred among a flock of more than 2000 Eurasian collared doves in Konarak, southeast of Iran. A confirmed pigeon paramyxovirus type 1 strain was isolated from the brain tissues of the dead doves. The isolate, which was called Pigeon/Iran/Konarak/Barin/2017, was classified as a highly velogenic NDV. Complete genome sequencing and phylogenetic analysis showed that the isolate belonged to subgenotype XXI.2, which has never been reported from Iran before. The isolate had the highest homology (96.15%) with early 2010s Italian isolates.Further studies will be required to understand the diversity better.
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Objectives@#No systematic review has explored the challenges related to worldwide universal health coverage (UHC). This study reviewed challenges on the road to UHC. @*Methods@#A systematic electronic search of all studies that identified the challenges of worldwide UHC was conducted, without any restrictions related to the publication date or language. A hand search and a bibliographic search were also conducted to identify which texts to include in this study. These sources and citations yielded a total of 2500 articles, only 26 of which met the inclusion criteria. Relevant data from these papers were extracted, summarized, grouped, and reported in tables. @*Results@#Of the 26 included studies, 7 (27%) were reviews, 6 (23%) were reports, and 13 (50%) had another type of study design. The publication dates of the included studies ranged from 2011 to 2020. Nine studies (35%) were published in 2019. Using the World Health Organization conceptual model, data on all of the challenges related to UHC in terms of the 4 functions of health systems (stewardship, creating resource, financing, and delivering services) were extracted from the included studies and reported. @*Conclusions@#This study provides a straightforward summary of previous studies that explored the challenges related to UHC and conducted an in-depth analysis of viable solutions.
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@#Introduction: Hand hygiene plays a huge role in removing hospital infections. The aim of this study was to explore the nurses’ viewpoints about the factors affecting hand hygiene compliance. Methods: In this qualitative content analysis study, the data were collected through purposive sampling and semi-structured interviews with 15 nurses. Interviews were audio-recorded and transcribed verbatim. Thematic analyses were conducted using Lundman and Graneheim’s method. Results: Six themes were identified, including the facilitator and barriers to compliance with hand hygiene on personal, interpersonal, and organizational levels. One theme was personal facilitator, with categories of facilitating the cognition and adherence to values. Personal barriers included cognitive obstacles, attitudinal barriers, and physical barriers. The interpersonal facilitators included supportive social climate and appropriate culture building. The interpersonal barriers involved inappropriate culture building and being under pressure. The organizational facilitators were strong leadership style, good managerial support, and competent staff evaluation; the last theme was organizational barriers with categories of poor leadership style, ineffective staff development, inconsistency in organizational policy, and incompetent staff evaluation. Conclusion: This study adopted an integrated approach to examining the factors affecting the nurses’ hand hygiene compliance. It is recommended that future interventions should consider the differences at individual, interpersonal, and organizational levels and developed a tailoring approach.
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ABSTRACT Objective: Globally developing metabolic syndrome (MetS) prevalence as a major health problem can be related to multiple factors of genetic and environmental. Dimethylaminohydrolase 2 (DDAH2) is the main enzyme implicated in the cardiovascular system, which regulates the nitric oxide pathway. This study investigated the association of DDAH2 polymorphism −499C/G (rs805305) with the risk of MetS among the Azar-Cohort population. Subjects and methods: The occurrence of SNP rs805305 in the DDAH2 gene was tested using the PCR-RFLP method in 332 MetS cases and 294 healthy controls. Afterward, the association of the allele and genotypes with the risk of MetS and its components were examined. Results: The G allele and GC genotype were significantly associated with a reduced risk of MetS (P ≤ 0.001). Also, the dominant genetic model (GG+GC) significantly decreased the risk of MetS (P = 0.001), however, in sex subtypes MetS risk was significantly reduced in males before and in females after adjustment for age (P ≤ 0.02). Conclusion: The −499C/G polymorphism of DDAH2 may play a protective role and reduce MetS risk among the Azar-Cohort population.
Subject(s)
Humans , Male , Female , Metabolic Syndrome/genetics , Amidohydrolases/genetics , Polymorphism, Genetic , Case-Control Studies , Promoter Regions, Genetic , Genetic Predisposition to Disease/genetics , Polymorphism, Single Nucleotide/genetics , Protective Factors , GenotypeABSTRACT
SUMMARY Carney complex (CNC) is a rare syndrome of multiple endocrine and non-endocrine tumors. In this paper we present a 23-year-old Iranian woman with CNC who harbored a novel mutation (c.642dupT) in PRKAR1A gene. This patient presented with pituitary macroadenoma, acromegaly, recurrent atrial myxoma, Cushing's syndrome secondary to primary pigmented nodular adrenocortical disease and pigmented schwanoma of the skin. PRKAR1A gene was PCR amplified using genomic DNA and analyzed for sequence variants which revealed the novel mutation resulting in substitution of amino acid cysteine instead of the naturally occurring valine in the peptide chain and a premature stop codon at position 18 (V215CfsX18). This change leads to development of tumors in different organs due to lack of tumor suppressive activity secondary to failure of synthesis of the related protein.
Subject(s)
Humans , Female , Adult , Young Adult , Acromegaly/genetics , Cushing Syndrome/genetics , Carney Complex/genetics , Myxoma/surgery , Myxoma/genetics , Cyclic AMP-Dependent Protein Kinase RIalpha Subunit/genetics , Iran , MutationABSTRACT
@#Introduction: Sleep disorder is one of the most common problems in elderly people. The present study is focused on the effectiveness of educational intervention on sleep quality and psychological well-being in the elderly people. Method: This is a Randomized educational field-controlled trial which was conducted on 90 elderlies with the sleep disorder, who have been selected using systematic random sampling from the clients of comprehensive health centers in Borazjan, Iran, 2019. The educational intervention was presented for 5 weeks by lecture, group discussions and virtual learning methods. Data were collected by the Pittsburgh Sleep Quality Index and the Ryff’s Psychological well-being scale before and 2 months after the intervention. The data were analyzed using SPSS-25 software using independent t-test, and Chi-square test. Results: The results showed significant statistical differences in sleep quality, subscales of sleep efficiency, sleeping time, and taking sleeping pills in experimental and control groups after the intervention (p≤0.005). Moreover, significant statistical difference was observed in terms of the mean scale of psychological well-being between experimental and control groups (p=0.036). Conclusion: Behavioral interventions can make various advantages for elderly people. Therefore, this study suggests providing such interventions in a wide range in comprehensive health centers, and boarding centers for the elderly.
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@#Introduction: Balance disorder is one of the huge risk factors for falling in elderly population. Falling leads to loss of independence of their functioning and activities of daily living. Preventing falls still exists as a challenge in public health. The aim of this study was to investigate the effect of balance exercise training on balance status, and quality of life in elderly women. Methods: In the study, 60 elderly women with dizziness and history of falling over the past 6-12 months were randomized allocated into experimental and control group. Berg Balance Scale (BBS) and Romberg tests, Dizziness Handicap Inventory (DHI), Fall Efficacy Scale-International (FES-I), and Leiden-Padua (LEIPAD) questionnaires were performed before and after training period in experimental group and compared to control group. Experimental group attended Cawthorne-cooksey (CC) and strengthening the sensory-motor system training in two-hour sessions twice in a week for 8 weeks. The repeated measure (one way and two way) ANOVA, independent-samples t-test, Bayesian Model, and ROC curve were applied to analysis the data using SPSS v.25. Results: Compared with the control group, BBS test result in 97% percent of the experimental group obtained normal. Experimental group improved significantly in the mean scores (ps<0.001) of BBS, Romberg, DHI, FES-I and some dimensions of life quality in LEIPAD. Conclusion: Balance exercises training (CC & strengthening the sensory-motor system) may induce significant improvements in balance and can be used for prevention or treatment in elderly people; further research is required to assess the long-term consequences of such interventions in elderly