Impact of spirituality on elderly people's quality of life and life satisfaction after acute myocardial infarction: Iranian hospital-based study.

BACKGROUND: As people age, survival after a heart attack can affect their quality of life and lead to a decrease in life satisfaction. After a myocardial infarction, elderly patients may experience physical, psychological, emotional and social changes that affect their thoughts and behaviour in relation to spirituality. AIMS: To investigate the relationship between spiritual well-being and other sociodemographic and medical history-related factors on quality of life and life satisfaction among elderly people after myocardial infarction. METHOD: In a census-based cross-sectional study conducted at the Imam Reza Hospital in Amol, Iran, from May 2020 to May 2021, data on sociodemographics, medical history, subjective well-being, life satisfaction and quality of life were collected from 502 participants who were referred at the heart clinic. RESULTS: The findings showed that spiritual well-being dimensions (religious well-being, [self-assessment of one's relationship with God], and existential well-being, [self-assessment of one's sense of purpose in life and life satisfaction]) were not significantly associated with life satisfaction, but a high perception of both dimensions of spiritual well-being were associated with higher self-reported quality of life. A history of past-year hospital admission and cardiopulmonary resuscitation were significant predictors of life satisfaction, and educational level was a predictor of quality of life. CONCLUSIONS: The study found no significant association between spiritual well-being and life satisfaction among elderly people following myocardial infarction. This finding might have been influenced by the physical and emotional challenges experienced by the participants during the COVID-19 pandemic. Further studies are needed to confirm this relationship.

Attitudes of Emergency Nurses and Patients' Family Members Towards the Presence of Family Members During Cardiopulmonary Resuscitation; a Cross-sectional Study.

Introduction: Family presence during cardiopulmonary resuscitation (CPR) is one of the elements where family-centered care is practiced. This study aimed to investigate the attitudes of Iranian emergency nurses and patients' family members regarding the presence of family during CPR. Methods: In a cross-sectional study, 350 emergency nurses and 254 family members of patients admitted to the emergency department of an educational hospital in Iran were enrolled. Data were collected from May to November 2020 using convenience sampling and using a 27-item questionnaire of participants' attitudes towards family presence during CPR. Results: The mean attitude scores of nurses and family members of patients regarding family presence during CPR were 86.79 ± 7.50 and 92.48 ± 6.77, respectively (p < 0.001). The highest and lowest mean scores of nurses' attitude towards family presence during CPR were related to "CPR performance will be negatively influenced" and "Family members have the right to be present during CPR of their relatives/ Allows relatives to stay with the patient until the end/ Makes the patient less worried ", respectively. The highest and lowest mean scores of family members' attitude towards family presence during CPR were related to "Family members may interfere with CPR" and " May be beneficial to the relatives' grieving process ", respectively. Conclusion: Overall, the results of this study showed that the attitude of emergency nurses and patients' family members towards family presence during CPR was positive. Of course, the mean attitude score of nurses in this regard was significantly lower.

Safety Assessment of Tretinoin Loaded Nano Emulsion and Nanostructured Lipid Carriers: A Non-invasive Trial on Human Volunteers.

BACKGROUND AND AIM: Topical application of tretinoin (TRE) is followed by a high incidence of side effects. One method to overcome the problem is loading TRE into lipid nanoparticles. The potential safety of the nanoparticle materials has been always considered as a major concern. In this in vivo study, changes in human skin biophysical parameters including hydration, TEWL, erythema, and pH have been used to determine the safety of tretinoin loaded nano emulsion (NE) and nanostructured lipid carriers (NLC). METHOD: TRE loaded NE and NLC were prepared using a high pressure homogenizer. Skin biophysical parameters were measured on the volar forearms of twenty healthy volunteers, before and after applying TRE-NE and TRE-NLC lotions. All the measurements were done using respective probes of MPA 580Cutometer®. RESULT: We obtained particles of nanometric size (<130 nm) with narrow distribution and optimal physical stability. None of the formulations made any statistically significant change in any of the measured skin properties. P-values were 0.646, 0.139, 0.386, 0.169 after applying TRE-NE and 0.508, 0.051, 0.139, 0.333 after applying TRE-NLC, respectively. CONCLUSION: Both formulations are reasonably safe to apply on human skin and topical application of TRE-NE and TRE-NLC had almost similar effects on skin biophysical parameters.

Simvastatin prevents morphine antinociceptive tolerance and withdrawal symptoms in rats.

BACKGROUND/PURPOSE: Long-term exposure to opiates induces tolerance to the analgesic effect and dependence. In recent years, several studies have been conducted to find agents that can prevent the development of these two phenomena. The aim of the present study is to evaluate the effect of simvastatin, a 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor, on morphine-induced tolerance and withdrawal symptoms. METHODS: Groups of male rats received daily morphine [for induction of tolerance (10 mg/kg) and for induction of dependence (additive doses: 5 mg/kg/12 h, 10 mg/kg/12 h, 15 mg/kg/12 h, 20 mg/kg/12 h, and 25 mg/kg/12 h)] in combination with propylene glycol or simvastatin [5 mg/kg, per os (p.o.), 10 mg/kg, p.o., and 20 mg/kg, p.o.]. Next, the nociception was assessed by the plantar test apparatus. The latency was recorded when the animal responded to the light stimulus. The animals received additional doses of morphine for 9 days in order to induce dependency. One hour after the last dose of the morphine injection, naloxone was administered and withdrawal symptoms were recorded for 1 hour. RESULTS: The results of the present study showed that chronic morphine administration induced tolerance to the analgesic effect for 19 days, whereas simvastatin (20 mg/kg, p.o.) delayed the day of the established tolerance by 5 days. The administration of simvastatin also prevented the morphine-induced shift to the right of the 50% effective dose (ED50) in the dose-response curve. Furthermore, the results showed that simvastatin decreased the total withdrawal score significantly. CONCLUSION: We found that simvastatin attenuated morphine-induced tolerance and withdrawal symptoms.

Malignant neoplasms of the sinonasal tract: report of 71 patients and literature review and analysis.

BACKGROUND: The present study aimed to report the characteristics, prognostic factors, and treatment outcomes of 71 cases of malignant neoplasms of the sinonasal tract and literature review and analysis of major report series. METHODS: Seventy-one consecutive patients diagnosed with primary malignant neoplasm of the sinonasal tract that were treated and followed up at a university hospital between May 2000 and March 2008 were selected for the present study. Thirty-four patients were treated with surgery followed by a combination of chemotherapy and radiotherapy, 15 with surgery alone, 14 with combined radiotherapy and chemotherapy, six with radiotherapy alone, and two with surgery followed by radiotherapy. To find out the major series of related studies over the last 20 years, a literature review of PubMed was performed. In all, we found 42 major series including 8,164 patients with malignant neoplasms of the sinonasal tract. RESULTS: There were 35 women and 36 men ranging in age from 5 to 80 years, with a median age of 55 years at diagnosis. The primary sites included were paranasal sinuses in 51 and nasal cavity in 20. There were one case of stage I, 20 of stage II, 27 of stage III, and 23 of stage IV. Epithelial tumors constituted 65% of all neoplasms. After a median follow-up of 39 months for surviving patients, 33 patients are alive and without disease, eight are alive with disease, and 30 patients died due to disease. Local recurrence was the most frequent treatment failure. The 5-year disease-free, local control, and overall survival rates were 42.1%, 59.5%, and 54.5%, respectively. On univariate analysis, cervical lymph nodes involvement, primary tumor size, histologic type, response to therapy, and stage of disease were independent prognostic factors for overall survival. In the literature review and by analyzing the data collection from 42 major reported series, the median age was 57 years and male/female ratio was 1.8. Epithelial tumors consisted of 69% of all malignant neoplasms of sinonasal tract and stages III and IV disease constituted 74.7% of all stages. Local recurrence was the dominant treatment failure in nearly all series. Five-year local control and overall survival rates were 56% and 45.5%, respectively. CONCLUSIONS: In this review and by analyzing the large data collection of recent major reported series, we found that malignant neoplasms of the sinonasal tract tend to present at locally advanced stage, with a high frequency of local failure and a moderate to poor outcome. More effective local treatment for improving the local control and overall survival is needed.