Ajuste de dosis según función renal en una paciente polimedicada incluida en el servicio de reacondicionamiento de medicamentos utilizando sistemas personalizados de dosificación (SPD) / Dose adjustment according to renal function in a polymedicated patient included in the medication reconditioning service using personalized dosing systems (SPD)

Paciente de 78 años, polimedicada e incluida en el servicio de Sistema Personalizado de Dosificación de Medicamentos (SPD). Al acudir a retirar su medicación nos informa que desde hace unos meses sufre cansancio, debilidad, mareos y confusión. Se realiza una revisión de la medicación, centrada en la dosificación de los medicamentos de metabolismo o eliminación renal, en función del valor de Filtrado Glomerular estimado de la paciente (FGe). Se realiza derivación al Médico de Atención Primaria (MAP) mediante un informe, en el que se recomienda la reducción de dosis de losartán y manidipino según el valor de FGe de la paciente. El MAP redujo la dosis de los antihipertensivos. Se efectuó seguimiento del caso, que permitió observar que la paciente dejó de presentar los síntomas descritos inicialmente.(AU)

Improving Fast Ripples Recording With Model-Guided Design of Microelectrodes.

OBJECTIVE: Microelectrodes allow the recording of neural activities with a high spatial resolution. However, their small sizes result in high impedance causing high thermal noise and poor signal-to-noise ratio. In drug-resistant epilepsy, the accurate detection of Fast Ripples (FRs) can help in the identification of epileptogenic networks. Consequently, good-quality recordings are instrumental in improving surgical outcomes. In this work, we propose a novel model-based approach for the design of microelectrodes optimized for FRs recording. METHODS: A 3D microscale computational model was developed to simulate FRs generated in the hippocampus. It was coupled with a model of the Electrode-Tissue Interface that accounts for the biophysical properties of intracortical microelectrode. This hybrid model was used to analyze the microelectrode geometrical and physical characteristics and their impact on recorded FRs. For model validation, experimental signals (local field potentials, LFPs) were recorded from CA1 using different electrode materials: stainless steel, gold, and gold coated with poly(3,4-ethylene dioxythiophene)/Poly(styrene sulfonate) (Au:PEDOT/PSS). RESULTS: results indicated that a radius between 65 and 120 µm for a wire microelectrode is the most optimal for recording FRs. In addition, in silico and in vivo quantified results showed a possible improvement in FRs observability using PEDOT/PSS coated microelectrodes. CONCLUSION: the optimization of the design of microelectrodes for FRs recording can improve the observability and detectability of FRs which are a recognized marker of epileptogenicity. SIGNIFICANCE: This model-based approach can assist in the design of hybrid electrodes that can be used in the presurgical evaluation of epileptic patients with drug-resistant epilepsy.

First detection of koi herpesvirus from koi, Cyprinus carpio L. experiencing mass mortalities in Iran: clinical, histopathological and molecular study.

Koi herpesvirus (KHV) is the aetiological agent of an emerging disease (KHVD) associated with mass mortalities in koi and common carp and reported from at least 30 countries. We report the first detection of KHV from koi in Iran using clinical, histopathological and molecular studies. KHV-infected fish showed reduced swimming activity, sunken eyes and increased mucus production on skin and fins. On post-mortem examination, gill necrosis was observed in the majority of fish. Histopathologically, the gill showed diffuse necrosis of the branchial epithelial cells. Margination of chromatin was detected in gills, kidney, heart, spleen, intestine and brain. In addition, sequence analyses of the TK gene, ORF 136 and marker I and II, demonstrates that Iranian KHV isolates were identical and classified as variant A1 of TUSMT1 (J strain) and displayed the I(++) II(+) allele of this Asian genotype.

On-line Ultrasound-Assisted Dispersive Micro-Solid-Phase Extraction Based on Amino Bimodal Mesoporous Silica Nanoparticles for the Preconcentration and Determination of Cadmium in Human Biological Samples.

On-line ultrasound-assisted dispersive micro-solid-phase extraction (USA-DµSPE) has been developed for preconcentration and separation of trace amounts of Cd(II) ions in 0.5 mL of human biological samples. In a syringe with a nylon membrane, new synthetic bulky amino bimodal mesoporous silica nanoparticles (NH2-UVM7) were dispersed as a nanoadsorbent in 5 mL of diluted serum sample (1:10), and after ultrasonic shaking, the liquid phase was separated from the solid phase. At the optimized pH, the chemical and physical adsorption of cadmium ions occurred, respectively, based on complexation with amine groups of UVM7 (Cd:NH2-UVM7) and silica nanoparticles. The analyte was then back-extracted from the sorbent with nitric acid solution (0.2 M), and its concentration was determined by electrothermal atomic absorption spectrometry (ETAAS). Under the optimized conditions, the linear range, limit of detection (LOD), and preconcentration factor (PF) were obtained as 0.01-0.56 µg L(-1), 0.002 µg L(-1), and 25, respectively. The adsorption capacity of NH2-UVM7 was found to be 108.6 mg g(-1) of cadmium. The validation of the methodology was performed by the human standard reference material (HSRM).

Liposarcoma or invasive lipomatosis in flower horn fish, hybrid cichlid: clinical, radiological, ultrasonographical and histopathological study.

Liposarcoma or invasive lipomatosis affecting three indoor aquarium fish (flower horn fish, hybrid cichlid) is characterized, by the presence of mature adipocytes of variable sizes and by an invasive behaviour, which affected internal organs and eyes of all cases. Detailed macroscopic, radiological, ultrasonographical and histopathological features are presented. All fish had bilateral exophthalmia with some masses around the eyes. Ultrasonography confirmed the presence of hyperechoic masses in the eyes. Histopathology of all cases described the presence of variable-sized adipose cells in the eyes. The suggested diagnosis is well-differentiated liposarcoma or invasive lipomatosis. This is the first report of liposarcoma or invasive lipomatosis in flower horn fish, hybrid cichlid.

The effect of radiology services outsourcing on patients' satisfaction in Tehran city hospitals.

Background: To have a developed society we should have healthy, active, and happy individuals and present that extended healthcare services perform an essential function in increasing the society's health level. Health in a society includes the society's, and people comfort with the condition and an assuring the situation that they can live healthily. Also, considering the self-governing plan of hospitals from 1995, the hospital authorities should choose a method of presenting services, and, the hospital is ready to present those activities during its own activities from an economic viewpoint. The current study was done while trying to discover the effect of the Outsourcing of the Radiology Unit on the patients' satisfaction in hospitals of Tehran. Method: The present research was done in a case-evidence and sectional study. Considering the weight of a month's references to the Radiology Unit, which included around 1200 individuals, the volume of samples for measuring the frequency of the patients' satisfaction with the means of Morgan table was similar to 291 individuals. To decrease the error percentage in each hospital we questioned 300 individuals. (n+10) were questioned and the gathered information were examined by what means SPSS application variant 21 and were then studied by climagraph - Smirnoph, Du Whitman - Vitney K tests. Findings: the mean of the patients' satisfaction of turned over and non-turned over Radiology Unit services were 41.46 and 45, respectively (from the maximum score of 60). A meaningful variation was seen among the patients' Satisfaction in the two hospitals from the analytical viewpoint (p-value<0.001) and there was also a significant difference between the patients' waiting time (p-value<0.001). The research's findings showed that the outsourcing has a negative influence on the patients' satisfaction and the duration of their waiting time. Conclusion: Many times, managers do the outsourcing without considering individual and organizational dimensions and characteristics by just justifying it based on decreasing the expenses. Therefore, it is essential for authorities to consider not only the economic characters but also the individual and human aspects while setting the outsourcing contracts and arrangements.

Relationship between learning styles and interpersonal communication skills of nursing student in Medical Sciences Tehran University in 2012.

Introduction: interpersonal communication skills are required for training and represent one of the most significant parts concerning the character of student learning. In another idea, learning is a constant method and learners favor a position of knowledge forms according to their character and individual practices. Evaluate the correlation between the learning methods and interpersonal conversation abilities of the nursing undergraduate in Medical Sciences Tehran University in 2012 was the purpose of this research. Methods: In this regular detailed cross-sectional analysis, 361 students from the School of Nursing and Midwifery were chosen during a census method. The information collection instruments were regulated, giving a questionnaire called Interpersonal Communication Skills Standards exam and VARK Learning Styles questionnaire. Data was examined by SPSS application (18th edition) by using Mann-Whitney and Kruskal-Wallis test. Results: 320 questionnaires were finished. 60.6% of the members were females. The average number of the students' conversation abilities level was 101.91 ± 10.35. More than half of the samples (58.8%) preferred multi-modal learning styles (Bi-Tri and Quad Modals) and 41.2% of the students preferred single modal learning styles. There were no significant differences between the Interpersonal Communication Skills and the learning styles (P= 0.46). Conclusion: According to no significant relationship between the communication skills of students with learning style and Demographic changeable and Lack of proper form of communication skills, we were ready to build different systems and courses related to improving the skills' level.

Solid phase preconcentration of iron as methylthymol blue complex on naphthalene-tetraoctylammonium bromide adsorbent with subsequent flame atomic absorption determination.

A sensitive and selective preconcentration method for the determination of trace amounts of iron by atomic absorption spectrometry has been developed. Iron forms a complex with methylthymol blue at pH=3. This complex is retained by naphthalene tetraoctylammonium bromide adsorbent in a column with a height of about 2cm. The adsorbed metal complex is then eluted from the column with nitric acid and its iron content is determined by flame atomic absorption spectrometry (FAAS). The effect of different variables such as pH, reagent concentration, flow rate and interfering ions on the recovery of the analyte was investigated. The calibration graph was linear in the range 25-350ngml(-1) of iron in the initial solution with r=0.9994. The limit of detection based on 3S(b) criterion was 12ngml(-1) and the relative standard deviation for eight replicate measurements of 150 and 300ngml(-1) of iron was 3.1 and 1.8%, respectively. This procedure was successfully applied to the determination of iron in tap and sewage water samples.

Continent ileocecal diversion with an unaltered in situ appendix conduit.

PURPOSE: We performed continent urinary diversion using an unaltered, in situ appendix to decrease the risk of appendicocolic manipulation. MATERIALS AND METHODS: Since September 1994, 19 patients a mean of 46.5 years old underwent continent urinary diversion with an ileocecal segment and an unaltered, in situ appendiceal conduit. In 1 case of a permanent colostomy we performed simple transposition of the appendix on the ileal pouch as a conduit, which to our knowledge is the first reported case. RESULTS: During the 4 to 24-month followup (mean 12) 17 patients were continent day and night, defined as being completely dry for 3 to 5 hours. Two patients were occasionally incontinent at night. One patient with a history of multiple operations who was completely incontinent achieved complete continence with endoscopic polytetrafluoroethylene (Teflon) injection at the appendicocecal junction. CONCLUSIONS: This unaltered in situ appendix technique is timesaving, safe, effective and comparable with other methods that provide urinary continence.