Comparing BTEX concentration related to surgical smoke in different operating rooms.

The available evidence on the indoor air quality of operating rooms (ORs) in the Low- and Middle-income Countries (LMICs) is very scarce. Moreover, there is no study on the comparing the concentration of indoor air pollutants in different ORs. Therefore, this study aimed to measure and compare the benzene, toluene, ethylbenzene and xylene (BTEX) concentrations in the air of different ORs in hospitals of Sabzevar, Iran. Moreover, carcinogenic and non-carcinogenic risk of exposure to these pollutants were assessed using Monte Carlo simulations technique. This cross-sectional study was based on volatile organic compounds (VOCs) passive sampling of eight ORs including General surgery, Curettage, Eye surgery, Neurosurgery, Orthopedic, Laparoscopic, Cesarean and Ear, nose, throat (ENT) in two monthly campaigns from November 2019 to February 2020. One-way ANOVA and Post-hoc analyses were used to compare the concentration of BTEX compounds in different ORs. The overall mean (standard deviation (SD)) of benzene, toluene, ethylbenzene, xylene and total BTEX concentrations were 10.0 (1.8), 7.2 (1.9), 1.8 (0.6), 0.4 (0.2) and 19.4 (4.1) µg/m3. The Curettage OR had the highest (12.93 µg/m3) and ENT OR had the lowest (7.42 µg/m3) benzene concentrations. The highest concentrations of toluene, ethylbenzene and total BTEX were observed in General surgery OR. The cancer risks of exposure to benzene in all ORs were higher than the acceptable range recommended by Unite State Environmental Protection Agency (USEPA, 1 × 106). However, the hazard quotient (HQ) values for all ORs were at safe level (HQ < 1). Overall, our study suggested that the concentrations of BTEX compounds were significantly difference in different ORs and benzene had a carcinogenic risk for personnel and surgical staff in different ORs.

Extracorporeal membrane oxygenation and COVID-19: The causes of failure.

INTRODUCTION: Venovenous extracorporeal membrane oxygenation (VV-ECMO) is a therapeutic strategy for the coronavirus disease 2019 (COVID-19) induced acute respiratory distress syndrome (ARDS). There are inconclusive data in this regard and causes of VV-ECMO failure are not yet understood well. CASE SERIES: Here, seven patients with COVID-19-induced ARDS who underwent VV-ECMO introduced and causes of VV-ECMO failure discussed. Medical records of seven COVID-19 patients treated with VV-ECMO were retrospectively evaluated to determine the clinical outcomes of VV-ECMO. Oxygenator failure occurred in four patients whom needed to oxygenator replacement. Successful VV-ECMO decannulation was done in three patients, however finally one patient survived. CONCLUSIONS: Hypercoagulability state and oxygenator failure were the most main etiologies for VV-ECMO failure in our study. All patients with COVID-19 undergoing VV-ECMO should be monitored for such problems and highly specialized healthcare team should monitor the patients during VV-ECMO.

Involvement of Endogenous Opioid System in Swim Stress-Induced Pain Modulation During the Interphase of the Formalin Test.

INTRODUCTION: Some evidence demonstrates endogenous inhibitory pathways of pain involved in the interphase (phase between early and later phase) of the formalin test. We previously showed that swimming stress modulates the pain-related behaviors during the interphase of the formalin test. In this study, we evaluated the role of the endogenous opioid system in modulating nociceptive responses of the formalin test. METHODS: Swim stress was performed in different heights of water (5, 25, 50 cm) in a swimming tank. The mean nociceptive scores were measured during phase 1 (1-7 min), interphase (8-14 min), and phase 2 (15-90 min) of the formalin test. Opioid receptor antagonist, naloxone (3 mg/kg; IP) was injected immediately before swim stress. RESULTS: Swim stress attenuated nociceptive behaviors in the first phase and increased the duration of interphase in the formalin test in a water-height-dependent manner, compared to the control group. Naloxone significantly increased nociceptive behaviors in the first phase, interphase, and the second phase of the formalin test, compared to the control group. CONCLUSION: Stress could affect the nociceptive response. Swim stress in different heights of water could have different effects on the nociception in different phases of the formalin test. In addition, the involvement of the endogenous opioid system is further demonstrated in the swim stress-induced modulation of pain behaviors in phase 1, phase 2, as well as interphase of formalin test in rats.

Modeling of Environmental Factors Affecting the Prevalence of Zoonotic and Anthroponotic Cutaneous, and Zoonotic Visceral Leishmaniasis in Foci of Iran: a Remote Sensing and GIS Based Study.

BACKGROUND: Leishmaniasis is a re-emerging serious international public health problem, and both visceral and cutaneous types of leishmaniasis became important endemic diseases in Iran. In this study, the relationships between environmental factors (vegetation and elevation) and the prevalence of diseases have been investigated. METHODS: All international and national online databases were searched by terms such as leishmaniasis, incidence, prevalence and other related words attributed to Iran and published until first quarter of 2015. The developed database in Excel, later imported to the ArcMap for spatial analyst and mapping. Afterwards, the software was used for modeling the relationship between the prevalence/incidence and environmental variables (vegetation and elevation) by both linear and nonlinear regression. RESULTS: After mapping the prevalence data from 144 studies, considering non-parametric ANOVA, the tendency of zoonotic visceral leishmaniasis to presence in high elevation and high vegetation was more than Anthroponotic and zoonotic cutaneous leishmaniasis. While linear regression showed weaker results for modeling, however, additive nonparametric regression analysis suggested that 10km buffers for elevation, and 10 as well as 50km buffers for vegetation could contribute in better fitness in modeling of these variables. CONCLUSION: The detailed maps for distribution of disease concluded. The nonlinear regression is a reliable predictor of the relationship between environmental factors and disease incidence, although more and wide researchers are needed to confirm it.

Prognostic Role of PTEN Gene Expression in Breast Cancer Patients from North-East Iran

Background: PTEN protein is one of the most important tumour suppressor factors which is detectable by immunohistochemistry. The goal of the present study was to investigate the prognostic role of PTEN gene expression in breast cancer patients. Materials and Methods: This descriptive-analytical study was conducted on 100 breast cancer patients referred to Sabzevar hospitals in the north-east of Iran between 2010 and 2011, who were followed up to 2015. PTEN gene expression in tissue samples was determined using specific monoclonal antibodies and data were analyzed using Chi-square test and Fisher's exact test. Patient survival was analyzed after 4 years of follow-up using the Cox regression model. Results: PTEN gene expression was evident in 70 of 100 cnacer samples but was found at high levels in all non-cancer samples. There was an inverse significant relationship between PTEN gene expression and tumour stage or tumour grade (p<0.001). The expression of PTEN in invasive ductal tumours was lower than in non-invasive tumours. There was also an inverse significant relationship between the hazard of death and PTEN gene expression (p<0.001). In addition, there was an inverse significant relationship between tumour stage and hazard of death (p<0.001). Conclusion: These findings indicate that lack of PTEN gene expression can be a sign of a worse prognosis and poor survival in breast cancer cases.

Prognostic Role of PTEN Gene Expression and Length of Survival of Breast Cancer Patients in the North East of Iran.

PTEN protein is an important tumour suppressor factor detectable by immunohistochemistry. The goal of the present study was to investigate the prognostic role of PTEN gene expression focusing on length of survival in breast cancer patients. This descriptive-analytical study was conducted on 100 breast cancer cases referred to Sabzevar hospitals in the north east of Iran between 2010 and 2011, followed up to 2015. The PTEN gene expression of tumour tissue samples was determined using specific monoclonal antibodies. The data were analyzed using Chi-square test and Fisher's exact test. Patient length of survival was analyzed after 4 years of follow-up using the Cox regression model. The PTEN gene was expressed in 70 of 100 samples, while being found at a high level in all noncancerous samples. There was an inverse significant relationship between expression of PTEN and tumour stage and grade (p<0.001). In addition, expression of PTEN in invasive ductal tumours was less than in non-invasive tumours. There was also an inverse significant relationship between the likelihood of death and PTEN gene expression (p<0.01). These findings indicate that lack of PTEN gene expression can be sign for a poor prognosis in breast cancer.