nurse-led telephone follow-up on medication and dietary adherence among patients after myocardial infarction: a randomized controlled clinical trial

Background: adherence to dietary and medication regimen plays an important role in successful treatment and reduces the negative complications and severity of the disease. Therefore, the present study aimed to investigate the effect of nurse-led telephone follow-up on the level of adherence to dietary and medication regimen among patients after Myocardial Infarction [MI]

Methods: this non-blinded randomized controlled clinical trial was conducted on 100 elderly patients with MI who had referred to the cardiovascular clinics in Shiraz. Participants were selected and randomly assigned to intervention and control groups using balanced block randomization method. The intervention group received a nurse-led telephone follow-up. The data were collected using a demographic questionnaire, Morisky's 8-item medication adherence questionnaire, and dietary adherence questionnaire before and three months after the intervention. Data analysis was done by the SPSS statistical software [version 21], using paired t-test for intra-group and Chi-square and t-test for between groups comparisons. Significance level was set at<0.05

Results: the results of Chi-square test showed no statistically significant difference between the intervention and control groups with respect to their adherence to dietary and medication regimen before the intervention [P>0.05]. However, a statistically significant difference was found between the two groups in this regard after the intervention [P<0.05]. The mean differences of dietary and medication adherence scores between pre- and post-tests were significantly different between the two groups. Independent t-test showed these differences [P=0.001]

Conclusion: the results of the present study confirmed the positive effects of nurse-led telephone follow-up as a method of tele-nursing on improvement of adherence to dietary and medication regimen in the patients with MI

Absence of Correlation between Changes in the Number of Endothelial Progenitor Cell Subsets

BACKGROUND AND OBJECTIVES: Previously, various methodologies were used to enumerate the endothelial progenitor cells (EPCs). We now know that these methodologies enumerate at least three different EPC subsets: circulating angiogenic cells (CACs), colony-forming unit endothelial cells (CFU-ECs), and endothelial colony-forming cells (ECFCs). It is not clear whether there is a correlation between changes in the number of these subsets. The aim of the current study is to find an answer to this question. MATERIALS AND METHODS: The number of all EPC subsets was quantified in the peripheral blood of nine pregnant women in their first and third trimesters of pregnancy. We enumerated 14 cell populations by quantitative flow-cytometry using various combinations of the markers, CD34, CD133, CD309, and CD45, to cover most of the reported phenotypes of CACs and ECFCs. Culturing technique was used to enumerate the CFU-ECs. Changes in the number of cells were calculated by subtracting the number of cells in the first trimester peripheral blood from the number of cells in the third trimester peripheral blood, and correlations between these changes were analyzed. RESULTS: The number of CFU-ECs did not correlate with the number of ECFCs and CACs. Also, CACs and ECFCs showed independent behaviors. However, the number of CACs showed a strong correlation with the number of CD133+CD309+ cells (p=0.001) and a moderate correlation with the number of CD34+CD309+ cells (p=0.042). Also, the number of ECFCs was correlated with the number of CD309+CD45- cells (p=0.029) and CD34+CD45- cells (p=0.03). CONCLUSION: Our study showed that the three commonly used methods for quantifying EPC subsets represent different cells with independent behaviors. Also, any study that measured the number of EPCs using the flow cytometry method with a marker combination that lacks CD309 may be inaccurate.

Corrected QT interval and QT dispersion in cirrhotic patients before and after liver transplantation

Liver cirrhosis is associated with different types of electrophysiological changes, including QT prolongation, which may adversely affect long-term prognosis of these patients. The aim of this study is to evaluate the effect of orthotopic liver transplantation [LT] on corrected QT [QTc] interval and QT dispersion [QTd] in cirrhotic patients of various etiologies. We enrolled 249 patients with end-stage liver disease between 2004 and 2009 at Shiraz Transplant Research Center, Shiraz, Iran. The QTc interval and QTd were measured by 12 lead ECGs for baseline and at 3 months after LT. Mean QTc interval and mean QTd were calculated. A QTc interval above 440 ms was considered abnormal. Within 3 months following surgery, 6 patients died. There were 105 patients [43.2%] with prolonged QTc before transplantation; in 91 [86.6%] patients, the mean QTc normalized after transplantation [baseline: 490.9 +/- 45.74 ms; post-transplantation: 385 +/- 48.74 ms; P < 0.0001]. Fourteen patients [13.3%] had evidence of some shortening of the QTc interval although the QTc remained above the upper limit of normal. Prolongation of the QTc interval in cirrhotic patients was independent of the etiology of cirrhosis. A normal QTc was seen in 138 patients [56.7%] before transplantation, of which 4 [2.9%] developed prolonged QTc after transplantation. The mean QTd decreased significantly after transplantation [baseline: 30 +/- 20 ms; post-transplantation: 30 +/- 10 ms; P < 0.0001]. Many cirrhotic patients have prolonged QTc intervals before LT regardless of disease etiology. In the majority of patients this value returns to normal after LT, suggesting that liver cirrhosis has independent unfavorable, but reversible electrophysiological effects

prevalence of coronary risk factors in Iranian Lor migrating tribe

Cardiovascular diseases are the major causes of death in Iran. The aim of this study was to determine the prevalence of conventional risk factors for coronary artery disease in Lor migrating tribes in southern part of Iran. Two hundred six persons of Lor migrating tribes in Mamasani, southern Iran [age range, 21 - 80 years] were randomly enrolled in the study. Their serum total cholesterol, triglyceride, high- density lipoprotein, low- density lipoprotein, and fasting blood sugar were determined. Of the participants, 79.9% were smokers. The prevalence of hypertension was 37.4% [mostly grade 1], 3.6% had diabetes mellitus, and 14.7% had impaired fasting glucose. A cholesterol level of more than 240 mg/dL was found in 7.1% of the participants, 27.8% had a low- density lipoprotein level of more than 130 mg/dL, 38.9% had a high- density lipoprotein level of less than 40 mg/dL, and 25.2% had a triglyceride level of more than 200 mg/dL. Body mass indexgreater than 25 was found in 34.8% of the participants, and 57.1% had intermediate and high risk for coronary events. The prevalence of conventional risk factors for coronary artery disease in Lor migrating tribes in comparison with Tehran urban population was very high