Determining the diagnostic value of three clinical criteria Wells', YEARS and modified Geneva in pregnant women with suspected pulmonary thromboembolism.

BACKGROUND: Diagnosis of pulmonary thromboembolism (PTE) during pregnancy is a challenging medical issue due to complications of X-ray-based imaging studies such as Ct-angiography for neonates and pregnant women. Here we aimed to assess the predictive values of three clinical criteria for diagnosing PTE during pregnancy. METHODS: This is a retrospective cohort study performed in 2018-2020 on 166 pregnant women suspected of PTE. We reviewed the documents of all patients referred to our medical center with suspected symptoms of PTE. The demographic characteristics of the patients, signs and clinical findings upon the arrival of patients as well as their laboratory tests including D-dimer with a history of abortion or delivery and leg symptoms were entered into the data collection form. Then, according to the information extracted from the patient's files, each patient was evaluated by all clinical PTE criteria, including Wells, YEARS and modified Geneva. For each patient according to clinical criteria and all three algorithms, clinical suspicion for PTE and treatment or non-treatment was determined were compared to the final MDCT result of patients. RESULTS: The Well's criteria had 100% sensitivity, 6.47% specificity, a positive predictive value of 7.8% and a negative predictive value of 100%. In patients with Well's score of more than four, the sensitivity and specificity of PTE diagnosis were 100% and 6% respectively. The modified Geneva criteria had 100% sensitivity, 8.89% specificity, a positive predictive value of 8.21% and a negative predictive value of 100%. The modified Geneva criteria had 100% sensitivity, 7.74% specificity, positive predictive value of 8.44% and a negative predictive value of 100%. CONCLUSION: Wells, YEARS and modified Geneva criteria could significantly rule out PTE in pregnancy with 100% sensitivity.

Diagnostic imaging to investigate pulmonary embolism in pregnancy using CT-Pulmonary angiography versus perfusion scan.

BACKGROUND: Pulmonary embolism (PE) is one of the major causes of maternal mortality; however, its diagnosis based on clinical presentation is a significant challenge; therefore, imaging is required. This study aims to determine the nondiagnostic rate of PE in pregnant women who initially undergone computed tomographic pulmonary angiography (CTPA) or perfusion scan. MATERIALS AND METHODS: In this cross-sectional study, all pregnant or 6-week postpartum women with clinical suspicion of PE were evaluated and underwent CTPA or perfusion scan between March 2017 and June 2019. The nondiagnostic rate of each method was defined as the outcome of this study. RESULTS: One hundred and eighty-two women with a clinical suspicion of PE were included, among which the initial imaging method was CTPA in 122 (67.03%) and perfusion scan in 60 (32.97%) women. The nondiagnostic imaging for CTPA was significantly lower than the perfusion scan (9 cases (7.4%) versus 25 cases (41.7%), respectively). Logistic regression assessment revealed a statistical outcome by controlling the confounders including gestational trimester at diagnosis, hypertension, ejection fraction, and tachycardia (odds ratio 15.911, 95% confidence interval: 5.177-48.897, P < 0.001). CONCLUSION: Based on the current study, CTPA is superior to perfusion scans to diagnose PE among pregnant or postpartum women with normal chest X-ray suspicion for PE.

(Im)mobilization of arsenic, chromium, and nickel in soils via biochar: A meta-analysis.

Biochar is a promising immobilizing agent of trace elements (TEs) in contaminated soils. However, several contradictory results have been reported regarding the potential of biochar to immobilize arsenic (As), chromium (Cr), and nickel (Ni) in contaminated soils. We conducted a meta-analysis on the published papers since 2006 until 2019 to examine the effects of biochar on the chemical (im)mobilization of As, Cr, and Ni in contaminated soils and to elucidate the major factors that control their interactions with biochar in soil. We synthesized 48 individual papers comprised of a total of 9351 pairwise comparisons and used the statistical tool of Cohen's d as an appropriate effect size for the comparison between means. We found that the application of biochar often increased the As mobilization in soils. Important variables that modulated the biochar effects on As mobilization in soil were pyrolysis temperature and time (ranging between 8 and 16 times when T > 450 °C and t > 1hr), organic matter (7-16 times when SOM<3%) and further site conditions. In contrast to As, biochar efficiently immobilized Cr and Ni in contaminated soils. The extent of the Cr and Ni immobilization was determined by the feedstock (Cr: 7-18 times for agricultural residue-derived biochar; Ni: 13-32 times for woody biomass-derived biochar). Our meta-analysis provides a compilation on the potential of different types of biochar to reduce/increase the mobilization of As, Cr, and Ni in various soils and under different experimental conditions. This study provides important insights on factors that affect biochar's efficiency for the (im)mobilization of As, Cr, and Ni in contaminated soils. While biochar effectively immobilizes Cr and Ni, a proper management of As-polluted soils with pristine biochar is still challenging. This limitation might be overcome by modification of biochar surfaces to exhibit higher surface area and functionality and active sites for surface complexation with TEs.

The value of epicardial adipose tissue thickness for outcome prediction of patients undergoing coronary artery bypass grafting surgery.

BACKGROUND: The significant association between epicardial adipose tissue and cardiovascular risk factors as well as outcome of ischemic heart diseases has been recently proposed. We determined the association between epicardial adipose tissue thickness and in-hospital as well as 3-month outcome after coronary artery bypass grafting surgery (CABG). MATERIALS AND METHODS: This cross-sectional study was performed on 78 consecutive patients who underwent CABG in our heart center. Associations between epicardial adipose tissue thickness and in-hospital as well as 3-month outcome after CABG were measured by logistic regression and value of epicardial fat thickness evaluated by receiver operating characteristic (ROC) curve analysis. RESULTS: Patients in-intensive care unit (ICU) suffered a variety of events, which many of them were insignificant, but 23 events (29.4%) of 78 were considered as important. The most frequent complication occurred in ICU was atrial fibrillation (9%). The frequency of 3-month complications was 6.4%, including 3.8% rehospitalization, 1.3% reoperation, and 1.3% cardiac death. Ninety-day mortality rate was 1.3%. Mean epicardial adipose tissue thickness was significantly higher in those with in-ICU complications than those without complication (7.64 ± 2.80 mm vs. 6.16 ± 2.29 mm, P = 0.015); however, the difference for 90-day complications was statistically nonsignificant. According to ROC curve analysis, measuring epicardial adipose tissue thickness could moderately predict in-ICU complication (area under the curve = 0.65 8, 95% confidence interval: 0.536-0.779, P = 0.017). The best cut-off point of this adipose tissue thickness for predicting in-ICU complication was 6.5 mm with sensitivity of 65.9% and specificity of 58.8%. CONCLUSION: Epicardial adipose tissue thickness is a useful predicting parameter for in-ICU complications after CABG.

Vitamin D down-regulates the expression of some Th17 cell-related cytokines, key inflammatory chemokines, and chemokine receptors in experimental autoimmune encephalomyelitis.

Objectives: A spectrum of immunomodulatory properties was attributed to vitamin D (VD). Here, the VD effects on expression of some Th17 cell- related cytokines, chemokines and chemokine receptors were investigated in experimental autoimmune encephalomyelitis (EAE). Methods: One group of C57BL/6 mice, considered as healthy group, was treated with phosphate buffered saline (PBS). EAE was induced in other three groups and treated from day +3 to +30 with PBS, olive oil (VD vehicle) or 200 ng of VD. At day 31, the expression of interleukin-17 (IL-17), IL-23, chemokine (C-C motif) ligand 20 (CCL20), CCL22, CC chemokine receptor 4 (CCR4) and CCR6 in spinal cord and serum IL-17 and IL-23 levels were measured by real-time PCR and ELISA, respectively. Results: The expression of IL-17, IL-23 P19, IL-23 P40, CCL20, CCL22 and CCR4 in spinal cord and serum IL-17 and IL-23 levels in PBS-administrated EAE mice were significantly increased compared with healthy group. In EAE mice treated with VD, the expression of aforementioned parameters was significantly reduced in comparison with PBS-administrated EAE mice. Conclusion: VD down-regulates the expression of some inflammatory cytokines, chemokines and chemokine receptors in EAE mice. The possible therapeutic potential of VD in multiple sclerosis can be considered in future investigation.

Ginger Extract Modulates the Expression of Chemokines CCL20 and CCL22 and Their Receptors (CCR6 and CCR4) in the Central Nervous System of Mice with Experimental Autoimmune Encephalomyelitis.

Background Chemokines facilitate the leukocytes infiltration into the central nervous system (CNS) which is an essential step in the pathogenesis of multiple sclerosis. Ginger has also a broad anti-inflammatory properties. The aim was to evaluate the effects of ginger extract on the expression of CCL20 and CCL22 and their receptors (CCR6 and CCR4, respectively) in experimental autoimmune encephalomyelitis (EAE). Material and Methods Female C57BL/6 mice used for EAE induction by immunization with myelin oligodendroglial glycoprotein. Then, the EAE mice were treated with PBS or ginger extract, from day +3 to +30. At day 31, mice were scarified and the expression of CCL20 and CCL22 and their receptors in the spinal cord measured using real time-PCR. Results The expression of CCL20, CCL22 and CCR4 in the spinal cord of PBS-administrated EAE mice was significantly higher than healthy group (P<0.04, P<0.05 and P<0.02, respectively). In 200- and 300 mg/kg ginger extract-treated EAE mice, the expression of CCL20, CCL22 and CCR4 were significantly reduced as compared with PBS-administrated EAE group (P<0.04, P<0.01 and P<0.002 for 200 mg/kg ginger extract and P<0.01, P<0.005 and P<0.004 for 300 mg/kg ginger extract, respectively). The CCR6 expression in EAE mice treated with 200- or 300 mg/kg ginger extracts was lower than PBS-administrated EAE mice (P<0.01 and P=0.07, respectively). Conclusion Treatment of EAE mice with ginger extract down-regulate the expression of CCL20 and CCL22 and their receptors in EAE mice. The possible therapeutic potential of ginger for treatment of MS can be considered in future investigations.

An Investigation into the Antifungal Property of Fabaceae using Bioinformatics Tools.

Chemodiversity in plants provides sources of great value which might be helpful for finding new leads in drug discovery programs. Fabaceae as the third largest family of flowering plants was chosen to investigate its possible antifungal activity. In order to increase the effectiveness of the result, molecular similarity methods and chemical data were used. Twelve plants were selected from Fabaceae and collected from the North and South of Iran. Percolation method with 80% ethanol was used for extraction of collected plants. Antifungal activities of these extracts were determined using broth microdilution method against Candida albicans (C. albicans) ATCC 10231, Aspergillus fumigatus (A. fumigatus) AF 293 and Asperigillus niger (A. niger) ATCC 16404. Extracts with promising activity were screened for toxicity with larvae of Artemia salina (brine shrimp). Dalbergia sissoo, Lathyrus pratensis, Oreophysa microphyalla, Astragalus stepporum, Ebenus stellata, Sophora alopecuroides, Ammodendron persicum and Taverniera cuneifolia showed activity against at least one of the microorganisms used in this study. According to the results of our experiment, the extracts of these plants can be used for further investigation in therapeutic research.