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1.
Mol Pharm ; 21(6): 2637-2658, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38728585

RESUMO

To date, the widespread implementation of therapeutic strategies for the treatment of chronic wounds, including debridement, infection control, and the use of grafts and various dressings, has been time-consuming and accompanied by many challenges, with definite success not yet achieved. Extensive studies on mesenchymal stem cells (MSCs) have led to suggestions for their use in treating various diseases. Given the existing barriers to utilizing such cells and numerous pieces of evidence indicating the crucial role of the paracrine signaling system in treatments involving MSCs, extracellular vesicles (EVs) derived from these cells have garnered significant attention in treating chronic wounds in recent years. This review begins with a general overview of current methods for chronic wound treatment, followed by an exploration of EV structure, biogenesis, extraction methods, and characterization. Subsequently, utilizing databases such as Google Scholar, PubMed, and ScienceDirect, we have explored the latest findings regarding the role of EVs in the healing of chronic wounds, particularly diabetic and burn wounds. In this context, the role and mode of action of these nanoparticles in healing chronic wounds through mechanisms such as oxygen level elevation, oxidative stress damage reduction, angiogenesis promotion, macrophage polarization assistance, etc., as well as the use of EVs as carriers for engineered nucleic acids, have been investigated. The upcoming challenges in translating EV-based treatments for healing chronic wounds, along with possible approaches to address these challenges, are discussed. Additionally, clinical trial studies in this field are also covered.


Assuntos
Vesículas Extracelulares , Células-Tronco Mesenquimais , Cicatrização , Vesículas Extracelulares/transplante , Vesículas Extracelulares/metabolismo , Humanos , Células-Tronco Mesenquimais/citologia , Células-Tronco Mesenquimais/metabolismo , Cicatrização/fisiologia , Animais , Transplante de Células-Tronco Mesenquimais/métodos , Doença Crônica , Ensaios Clínicos como Assunto , Queimaduras/terapia
2.
J Nematol ; 56(1): 20240015, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38650604

RESUMO

Nothotylenchus savadkoohensis n. sp. was recovered from rotten wood samples of an unidentified forest tree in the Mazandaran province and described herein. It is mainly characterized by an elongated conoid tail ending in a sharply pointed tip and four lines in the lateral field. Females of the new species have 379-662 µm long bodies with 5.8-6.9 µm long stylets ending in fine posteriorly sloping knobs, the metacorpus not valvate, the pharyngeal bulb slightly overlapping the intestine, and the vulva at 76.5-84.0% of body length. Males are also common and have 13.0-14.5 µm long spicules and bursa cloacal. By having an elongated conoid tail and four lines in the lateral field, the new species comes close to four known species, namely N. acris, N. acutus, N. antricolus, and N. truncatus. The morphological differences between the new species and the abovementioned species are discussed. The new species was sequenced for its D2-D3 segment of LSU and ITS rDNA regions. In the LSU phylogenetic tree, the currently available LSU sequences of the genus Nothotylenchus occupied distant placements from each other and the LSU sequence of the new species formed clade with a sequence assigned to Neotylenchus sp. In ITS phylogeny, the newly generated sequence of the new species formed a clade with a clade that includes sequences of Ditylenchus sp. and Neomisticius platypi and N. variabilis.

3.
Macromol Biosci ; 24(3): e2300353, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37939368

RESUMO

Diabetic foot ulcer (DFU) is the most critical problem in diabetic patients. Managing exudate in this kind of wound presents significant challenges in clinics. Advanced wound dressings serve as the most effective approach to managing DFU. Herein, a highly absorbent hydrofilm is presented through a combination of egg white (EW) and Carbomer-940, benefiting from the bioactivity of the EW component and superabsorption capacity of Carbomer-940. The crystallinity of samples rises due to the presence of Carbomer-940. Regarding the high water absorption capacity of Carbomer-940, the swelling ratio and water-holding capacity of samples are also improved via its incorporation of up to 1005%. In contrast, the transmission of water vapor and in vitro degradation rate decreases as Carbomer-940 powers the crystallinity of hydrofilms. Carbomer-940 incorporation in the EW structure accelerates protein release during the time, while this acceleration is partially compensated by the crystallization effect. The cell viability assay demonstrates no toxicity as well as high human foreskin fibroblast cell proliferation for the hybrid hydrofilm sample, where the cell migration is positively affected in the presence of the bioactive components extracted from the dressing. Taken together, the optimized hybrid hydrofilm could be suggested as a promising wound dressing for managing DFUs.


Assuntos
Resinas Acrílicas , Diabetes Mellitus , Pé Diabético , Humanos , Clara de Ovo , Cicatrização , Bandagens , Pé Diabético/terapia
4.
Res Pharm Sci ; 18(4): 346-357, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37614613

RESUMO

Background and purpose: Though controversial, many clinical trials have been conducted to evaluate the efficacy of intravenous immunoglobulins (IVIG) in COVID-19 cases. Therefore, a systematic review and meta-analysis have been performed to evaluate the efficacy of IVIG in the treatment of COVID-19 patients. Experimental approach: A systematic search was performed in electronic databases and preprint servers up to November 20, 2021. Since substantial heterogeneity was expected, a random-effects model was applied to pool effect size from included studies to calculate the standardized mean differences (SMDs) for the continuous variables and relative risks (RRs) for the dichotomous variable with 95% confidence intervals (CIs). Findings/Results: Five randomized clinical trials and seven cohort studies were analyzed among the 12 eligible studies with a total of 2,156 patients. The pooled RR of mortality was 0.77 (CI 0.59-1.01, P-value = 0.06), and of mechanical ventilation was 1.50 (CI 0.29-7.83; P-value = 0.63) in the IVIG group compared with the standard care group. The pooled SMD of hospital length of stay was 0.84 (CI -0.43-2.11; P-value = 0.20) and of ICU length of stay was -0.07 (CI -0.92-0.78; P-value = 0.86) in the IVIG group compared with the standard care group. Conclusion and implications: This meta-analysis found that the IVIG therapy was not statistically different from the standard care group. Mortality, ICU admission, mechanical ventilation, length of hospital stay, and length of ICU stay were not significantly improved among IVIG recipients. However, statistical indifference is not equal to clinical indifference.

5.
Heliyon ; 9(6): e17636, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37416676

RESUMO

The increase in the need for food and agricultural development has led to an increase in the use of insecticides. The use of insecticides leads to air, soil and water pollution. This study investigated the pollutant concentration cycle in the environment by analyzing diazinon and deltamethrin in a river and groundwater sources affected by an agricultural area. The samples were analyzed based on the standard method for insecticides in water using a GC-MS. The results showed that the quality of the surface water affected by the agricultural effluents decreased so that the changes of dissolved oxygen, nitrate, turbidity, TOC, BOD, and COD were 15.2%, 189.6%, 00%, 53%, 176%, and 57.5%, respectively. The concentration of diazinon and deltamethrin in agricultural wastewater was 86 µg/L and 11.62 µg/L. The self-treatment capacity of the river reduced the concentration of diazinon in the distance of 2 km and 15 km by 80.8% and 90.3%, respectively. These conditions were observed for deltamethrin in 74.8% and 96.2%, respectively. Also, the concentration of the two insecticides in water resources has temporal and spatial variation. The difference between the maximum and minimum concentration of diazinon and deltamethrin at different times was 183.5 and 1.73, respectively. The concentration of diazinon and deltamethrin in the downstream groundwater of the studied irrigated area was 0.3-0.7 µg/L, respectively. Although the soil structure and the self-purification capacity of the river caused a significant reduction of insecticides, the remained concentration of these pollutants in underground and surface water resources can still be a health and environmental concern.

6.
BMC Geriatr ; 23(1): 208, 2023 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-37003968

RESUMO

BACKGROUND: Following the rapid aging of population, some concerns have emerged regarding increasing demand for health care services and the consequent increase in health costs. Besides, older adult patients with chronic disease are more prone to show cost-related medication non-adherence (CRN) to cope with their medication costs. The objective of this qualitative study was to develop an adopted conceptual framework on the contextual determinants that affect the CRN in older adult patients with chronic diseases. METHODS: Problem-centered, semi-structured, in-depth, and face-to-face interviews, were conducted with healthcare informants in Iran, from Sep. 2021 to Feb. 2022. Collected data were analyzed using deductive and inductive analytic approaches and content analysis methodology was used to develop the model. This study applies to the COREQ checklist. RESULTS: Fifteen informants, including 8 (60%) males, with mean ± SD age of 44.4 ± 9.7 years, entered into the study. Based on the data analysis performed on the information obtained from the interview with 3 subgroups of geriatricians, health policymakers, and pharmacists, six major themes identified as determinants: 1) socio-economic factors, 2) health system-related factors, 3) healthcare provider-related factors, 4) medication-related factors, 5) disease-related factors, and 6) patient-related factors. There were also 23 minor themes which were matched with the aforementioned six major themes. CONCLUSION: The final framework obtained in this qualitative study depicts CRN as an issue that is highly likely affected by six main determinants among older patients with chronic disease. Our findings emphasize that policymakers would focus on certain major themes and allocate resources to programs to improve medication therapy management in older adult patients.


Assuntos
Adesão à Medicação , Masculino , Humanos , Idoso , Feminino , Irã (Geográfico)/epidemiologia , Doença Crônica , Pesquisa Qualitativa
7.
Health Lit Res Pract ; 6(3): e191-e199, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35943838

RESUMO

BACKGROUND: Heart failure is a costly condition with high morbidity and mortality rates in low- and middle-income countries. Nonadherence to prescribed therapies can lead to severe problems such as poorer health outcomes, higher health care expenditures, increased hospitalizations, and even higher mortality rates in patients with advanced heart disease. OBJECTIVE: The aim of the present study is to investigate medication adherence and the association between medication adherence and health literacy in Iranian patients with heart failure. METHODS: This study was conducted in the heart failure outpatient clinic of Shahid Rajaee Cardiovascular, Medical, and Research Center in Tehran, Iran. Medical records and validated questionnaires were used to collect the necessary information on the survey variables, including sociodemographic characteristics, medication adherence, and health literacy, for a total of 250 patients with heart failure. Stepwise logistic regression analysis was performed to identify the variables that independently and significantly predicted medication nonadherence. KEY RESULTS: The results showed that most patients with heart failure had low medication adherence. Some factors, including gender, health literacy, and duration of illness, were associated with adherence. The study results showed a positive association between higher health literacy and better medication adherence. CONCLUSION: In view of the results, further studies on heart failure are needed to investigate other factors related to medication adherence and health literacy level to achieve better disease management and improve patients' treatment adherence. [HLRP: Health Literacy Research and Practice. 2022;6(3):e191-e199.] Plain Language Summary: This study investigated the relationship between medication adherence and health literacy in Iranian patients with heart failure. The results showed that most patients had inadequate health literacy. Moreover, it showed a significant and positive relationship between health literacy and medication adherence.


Assuntos
Letramento em Saúde , Insuficiência Cardíaca , Estudos Transversais , Insuficiência Cardíaca/tratamento farmacológico , Humanos , Irã (Geográfico) , Adesão à Medicação
8.
BMC Prim Care ; 23(1): 113, 2022 05 10.
Artigo em Inglês | MEDLINE | ID: mdl-35538417

RESUMO

BACKGROUND: Medication adherence among Psoriasis patients is often inadequate identified as a significant problem in Psoriasis symptoms management. Poor medication adherence could necessitate stronger and more expensive medications, which could place a significant burden on the healthcare system. Moreover, the importance of health literacy assessment as a factor influencing adherence in psoriasis patients cannot be overstated. This study aimed to evaluate the medication adherence level of Iranian Psoriasis patients and its relationship with the patients' health literacy level and demographic conditions. METHODS: This is a cross-sectional study among Iranian psoriasis patients conducted through a web-based questionnaire survey between 26 July 2020 and 5 January 2021 and a total of 575 samples were collected. The questionnaire consisted of 3 sections: First, demographic information and disease characteristics were evaluated. Second, the medication adherence was evaluated by using valid Morisky Medication Adherence Scale-8 (MMAS-8), and, finally, the health literacy was evaluated by using Health Literacy for Iranian Adults (HELIA). Data were analyzed using SPSS software, version 22 with descriptive statistics; Chi-square and Kruskal-Wallis tests. Stepwise multiple linear regression was also used to evaluate the impact of independent variables related on medication adherence score. RESULTS: Results showed that the mean health literacy score in the study population was 74.3 ± 14.23, and the mean medication adherence score was 4.1 ± 2.18. Out of the total participants, 28.8% had high health literacy, 67.1% had adequate health literacy, and 4% had inadequate health literacy. The majority of the participants (70.7%) reported low adherence, while 24.1% reported moderate and 5.2% reported high adherence. The results of the Chi-square test showed a significant relationship between age, comorbidities, type of treatment, satisfaction with treatment, the experience of adverse effects, and health literacy with medication adherence (P < 0.05 for all). The final constructed model of stepwise multiple linear regression was highly statistically significant. The highest beta coefficient in the final model belonged to the total health literacy score. CONCLUSIONS: Based on the results, medication adherence among Iranian psoriasis patients is low. Health literacy correlates most strongly with medication adherence and is the best variable to determine it. Improving the access to the internet and the ICTs to enhance the patients` health literacy along with developing the patient education approaches and techniques should be considered by health policymakers.


Assuntos
Letramento em Saúde , Psoríase , Adulto , Estudos Transversais , Humanos , Irã (Geográfico)/epidemiologia , Adesão à Medicação , Psoríase/tratamento farmacológico , Inquéritos e Questionários
9.
Expert Rev Clin Pharmacol ; 15(6): 767-777, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35579011

RESUMO

OBJECTIVES: Performing an updated meta-analysis to compare the safety and efficacy of insulin glargine and insulin detemir in adults with type 1 and type 2 diabetes. METHODS: Electronic databases were searched up to 18 August 2021. A random-effects model was applied to pool data from included studies to calculate the standardized mean differences (SMDs) for the continuous variables and relative risks (RRs) for the dichotomous variable. RESULTS: Nine studies compared insulin detemir and insulin glargine in type 2 diabetes and three studies in patients with type 1 diabetes. The pooled SMD of weight gain was -0.59 (95% CI -1.05 to -0.14; P=0.01; I2=98%) in patients with type 2 diabetes. The pooled RR of severe hypoglycemia was 0.28 (95% CI 0.12 to 0.63; P=0.002; I2=0%) in patients with type 1 diabetes. The effects of detemir and glargine on HbA1c, fasting plasma glucose, nocturnal hypoglycemia, and overall hypoglycemia were not statistically different (P>0.05). CONCLUSIONS: It was found that there is no clinically considerable difference between the impacts of insulin detemir and insulin glargine in diabetic patients. The only statistically significant differences were less weight gain in type 2 diabetes and fewer episodes of severe hypoglycemia in type 1 diabetes with insulin detemir.


Assuntos
Diabetes Mellitus Tipo 1 , Diabetes Mellitus Tipo 2 , Hipoglicemia , Adulto , Glicemia , Diabetes Mellitus Tipo 1/tratamento farmacológico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Hemoglobinas Glicadas , Humanos , Hipoglicemia/induzido quimicamente , Hipoglicemiantes/efeitos adversos , Insulina , Insulina Detemir/efeitos adversos , Insulina Glargina/efeitos adversos , Insulina de Ação Prolongada/efeitos adversos , Aumento de Peso
10.
ARYA Atheroscler ; 18(3): 1-12, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-36815952

RESUMO

BACKGROUND: Ischemic heart disease (IHD) is the first cause of mortality in the world. Stable coronary artery disease (CAD) is the most common IHD. Medical therapy (MT), percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG) are three strategies for the management of this disease. The main aim of this study was the comparison of MT with PCI or CABG in terms of cardiovascular (CV) mortality, myocardial infarction (MI), unplanned revascularization (UR), stroke, and freedom from angina in managing stable CAD. METHODS: The Cochrane Central Register of Controlled Trials, Embase, PubMed, and Scopus were searched. Two reviewers independently appraised the titles and abstracted data of the identified studies. After the Full-text reviewing phase, eligible studies were analyzed through the random-effect meta-analysis method. Finally, a sensitivity analysis was conducted for the robustness of findings. RESULTS: Nine randomized controlled trials (RCTs) were included. The pooled RR of CV mortality associated with MT compared with PCI and CABG was 1.22 and 1.385, respectively. Overall, The RR of MT associated with MI, UR, stroke, and freedom from angina compared with PCI was 1.001, 1.151, 0.799, and 0.801, respectively. CONCLUSION: Our results revealed no statistically significant difference between MT and PCI in terms of studied primary outcomes. The findings also highlighted that there is no statistically significant difference between MT and CABG in terms of CV mortality.

11.
J Psychosoc Nurs Ment Health Serv ; 59(10): 41-47, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34142915

RESUMO

The current study examined the effectiveness of a life skills training intervention on the psychological health of adolescents and young adults with type 1 diabetes. This quasi-randomized controlled trial recruited 80 individuals from the West Azerbaijan Diabetes Community in Urmia, Iran. Participants were randomly allocated to intervention (n = 40) or control (n = 40) groups. The intervention group received nine sessions of life skills training, and the control group received routine care only. Data collection tools included a demographics questionnaire and the Depression, Anxiety, and Stress Scale. Compared to the control group, intervention group participants achieved statistically significant improvements in their physiological health, including stress (p < 0.04), anxiety (p < 0.04), and depression (p < 0.03). Nurses, including diabetes educators, should assess patients with diabetes for psychological complications and consider empowering adolescents and young adults with diabetes through life skills training, which can be incorporated into diabetes management plans to promote health and well-being. [Journal of Psychosocial Nursing and Mental Health Services, 59(10), 41-47.].


Assuntos
Diabetes Mellitus Tipo 1 , Saúde Mental , Adolescente , Ansiedade , Depressão , Diabetes Mellitus Tipo 1/terapia , Promoção da Saúde , Humanos , Qualidade de Vida , Inquéritos e Questionários , Adulto Jovem
12.
Expert Rev Clin Immunol ; 17(5): 499-511, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33823733

RESUMO

OBJECTIVES: Currently published papers and clinical guidelines regarding the effects of tocilizumab in severe and critical COVID-19 are contradictory. The aim of this meta-analysis was to combine the results of clinical studies of different designs to investigate the efficacy and safety of tocilizumab in severely-to-critically ill COVID-19 patients. METHODS: A systematic search was performed in PubMed, Embase, CENTRAL, ClinicalTrials.gov, Scopus, and preprint servers up to 26 December 2020. Since a substantial heterogeneity was expected, a random-effects model was applied to calculate the pooled effect size (ES) and 95% confidence interval (CI) for each study outcome. RESULTS: Forty-five comparative studies involving 13,189 patients and 28 single-arm studies involving 1,770 patients were analyzed. The risk of mortality (RR of 0.76 [95%CI 0.65 to 0.89], P < 0.01) and intubation (RR of 0.48 [95%CI 0.24 to 0.97], P = 0.04) were lower in tocilizumab patients compared with controls. We did not find any significant difference in secondary infections, length of hospital stay, hospital discharge before day 14, and ICU admission between groups. CONCLUSION: Tocilizumab can improve clinical outcomes and reduce mortality rates in severe to critical COVID-19 patients. Large-scale randomized controlled trials are still required to improve the statistical power of meta-analysis.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Tratamento Farmacológico da COVID-19 , SARS-CoV-2 , Índice de Gravidade de Doença , Anticorpos Monoclonais Humanizados/efeitos adversos , Humanos
13.
Expert Rev Pharmacoecon Outcomes Res ; 21(4): 775-784, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33043757

RESUMO

BACKGROUND AND OBJECTIVE: This study aimed to evaluate the cost-utility of Tofacitinib (TFC) in patients with severe rheumatoid arthritis (RA) who had not responded well to methotrexate from the Iranian payer's perspective. METHODS: An individual microsimulation Markov model was developed to compare TFC with etanercept (ETN) and Adalimumab (ADA) over a life-time horizon. Treatment efficacy was estimated based on the American College of Rheumatology (ACR) response improvement criteria in 6 months. Changes in the Health Assessment Questionnaire (HAQ) scores were mapped onto utility values to calculate outcomes in terms of QALYs. Direct medical costs were taken from national databases. Uncertainty in model parameters was evaluated by sensitivity analyses. RESULTS: This study demonstrated that TFC was cost-effective in both scenarios. Although TFC was associated with lower QALYs than ETN (6.664 versus 6.876), it was also associated with lower costs over a life-time horizon ($42,565.04 versus $58,696.29). Additionally, TFC was found to be the dominant strategy with a lower cost ($50,299.91 versus $51,550.29) and higher QALYs gained (6.900 versus 6.687) compared to ADA. CONCLUSION: TFC was found to be cost-effective in patients with severe RA who do not respond well to methotrexate compared to ADA, ETN in Iran.


Assuntos
Adalimumab/administração & dosagem , Antirreumáticos/administração & dosagem , Artrite Reumatoide/tratamento farmacológico , Etanercepte/administração & dosagem , Piperidinas/administração & dosagem , Pirimidinas/administração & dosagem , Adalimumab/economia , Adulto , Antirreumáticos/economia , Artrite Reumatoide/economia , Análise Custo-Benefício , Etanercepte/economia , Feminino , Humanos , Irã (Geográfico) , Masculino , Cadeias de Markov , Metotrexato/administração & dosagem , Pessoa de Meia-Idade , Piperidinas/economia , Pirimidinas/economia , Anos de Vida Ajustados por Qualidade de Vida , Índice de Gravidade de Doença , Inquéritos e Questionários , Resultado do Tratamento
14.
J Educ Health Promot ; 9: 188, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32953914

RESUMO

BACKGROUND: Iran has experienced an increasing number of earthquake disasters in the past three decades. Due to nurses' unique role as professional and volunteer responders in times of disaster, more information is required regarding the capabilities they need to provide more effective care during the crisis. The aim of this study was to identify professional capabilities needed by nurses to provide care to the injured of earthquake. MATERIALS AND METHODS: The present study was conducted as a qualitative conventional content analysis, and data collection was carried out through 16 semi-structured and in-depth interviews with the nurses involved in providing care to the injured in the Kermanshah earthquake. The data were analyzed following Graneheim and Lundman's approach. RESULTS: Data analysis led to the emergence of 427 primary codes, 10 subcategories, and four categories. The four categories included clinical competence (professional knowledge and clinical skills), personal competences (communication skills, resiliency, and creativity and innovation in providing care), ethical competence (commitment to ethics and professional responsibility), and essential skills in caring for the injured (skills in triage, psychological care skills, and skills in observation and monitoring). CONCLUSION: The present study identified a wide range of professional capabilities required by nurses in disasters. Given that nurses do not acquire some of these specialized and technical skills during their education, it is recommended to enhance the professional capacity of nurses in disasters. In addition, special training programs in this field can be incorporated into the curriculum of nursing programs and in-service nursing education.

15.
J Environ Health Sci Eng ; 18(1): 163-175, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32399229

RESUMO

Because of the presence of tannin in the molecular structure of oak extract, this substance is used as a natural coagulant to remove turbidity from water. The aim of this study was to determine the efficiency of this coagulant alone and in combination with polyaluminium chloride (PACl) in turbidity removal from water under optimal conditions. In this experimental study, Iranian oak extract was prepared by maceration method using ethanol 96% as an extractor. Kaolin was used to prepare synthetic turbid water samples. Using the jar test, the optimum concentrations of oak extract and PACl were determined in various concentrations of initial turbidity and pH. Moreover, the central composite design (CCD) method was utilized to design experiments and RSM was applied for analyzing the obtained results. Optimum concentrations of oak extract and PACl were 62.6 mg/L and 52.6 mg/L, respectively. An increase in initial turbidity and pH led to an increase in turbidity removal by the two coagulants. The efficiency of turbidity removal by oak extract and PACl was 63.5% and 66.5%, respectively. The simultaneous application of oak extract and polyaluminium chloride increased removal efficiency (85%) and reduced the total organic carbon concentration (TOC) in water (42.3%). The results showed that the simultaneous application of Iranian oak extract and polyaluminium chloride had an acceptable performance in removing turbidity from water.

16.
Nurs Ethics ; 27(4): 911-923, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32264790

RESUMO

BACKGROUND: Ethical care provided by nurses to earthquake victims is one of the main subjects in nursing profession. OBJECTIVES: Given the information gap in this field, the present study is an attempt to explore the nurses' experience of ethical care provided to victims of an earthquake. RESEARCH DESIGN AND METHOD: A hermeneutic phenomenological study was performed. The participants were 16 nurses involved in providing care to the injured in Kermanshah earthquake, Iran. They were selected using purposeful sampling, and in-depth and semi-structured interviews were carried out. The transcribed interviews were analyzed based on the hermeneutic approach using the analysis method proposed by Diekelmann et al. ETHICAL CONSIDERATIONS: The study was approved by the Research Council and Ethics Committee of Urmia University of Medical Sciences, Iran. FINDINGS: Data analyses revealed four themes and 10 sub-themes that illustrated nurses' experience of ethical care during earthquake. The themes were (1) Respecting humanistic values (sacrifice, stepping beyond task description, and voluntary work), (2) Commitment to ethics (honesty, confidentiality, and trustworthiness), (3) Respecting dignity of victims (respecting cultural values, maintaining privacy, having humanistic perspective, and effective communication), and (4) Spiritual support (helping patients to do religious rituals Psychological support). CONCLUSION: The results showed the nurses' experience with providing care to earthquake victims. The findings underlined ethics and ethical values in providing nursing care during disasters. It is suggested that special courses on the importance of nursing ethics in critical situations be incorporated into nursing curriculums and in-service educations.


Assuntos
Atitude do Pessoal de Saúde , Vítimas de Desastres , Terremotos , Enfermeiras e Enfermeiros/psicologia , Cuidados de Enfermagem/ética , Recursos Humanos de Enfermagem Hospitalar/psicologia , Adulto , Feminino , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa
17.
Complement Ther Med ; 49: 102341, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32147030

RESUMO

AIM: Present review aimed to conduct a comprehensive review of the effectiveness of non-pharmacological interventions (NPIs) on reducing anxiety in adult burn patients. METHOD: We searched PubMed, Web of Science, Scopus, Cochrane Library, and Google Scholar databases through September 2019 for randomized clinical trials comparing NPIs to a control group. The primary outcomes were general anxiety and pain anxiety. The Cochrane Risk of Bias Tool was used to assess the risk of bias. All data was pooled with Revman 5.3. RESULTS: 20 studies were eligible for quantitative synthesis. Compared to routine care, Music (4 Randomized Clinical Trials (RCTs), Standardized Mean Difference (SMD) = -2.00, 95 % Confidence Interval (CI) = -3.21 to -0.79), massage (4 RCTs, SMD= -1.84, 95 % CI= -2.77 to -0.91), hypnosis (2 RCTs, SMD= -1.06, 95 % CI= -2.90 to 0.78), relaxation (2 RCTs, SMD= -0.77, 95 %CI= -1.52 to -0.02), transcranial direct current stimulation (1 RCT, SMD= -1.92, 95 %CI= -2.54 to -1.30), and therapeutic touch practices (1 RCT, SMD=-0.45 95 %CI= -0.86 to -0.04), were associated with a significant effect on the anxiety of burn patients. Aromatherapy interventions and virtual reality showed no evidence of a reduction in the anxiety. A large amount of heterogeneity exist among trials. Risk of bias varied across studies. Only one study reported on safety issues. CONCLUSION: Due to weak evidence, we are unable to make strong recommendations in favor of NPIs for burn anxiety. Further well-designed large sample size randomized clinical trials are warranted.


Assuntos
Ansiedade/etiologia , Ansiedade/terapia , Queimaduras/complicações , Queimaduras/psicologia , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
18.
J Recept Signal Transduct Res ; 39(5-6): 442-450, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31766932

RESUMO

The control of permeation is vital not only for the topical application of lotions, creams, and ointments but also for the toxicological and risk assessment of materials from environmental and occupational hazards. To understand the effects of physicochemical properties of a variety of 211 compounds on skin permeability, we developed a three-dimensional quantitative structure-property relationship (3 D-QSPR) model. Alignment free GRid-INdependent Descriptors (GRINDs), which were derived from molecular interaction fields (MIFs) contributed to the regression models. Kennard-Stone algorithm was employed to split data set to a training set of 159 molecules and a test set of 52 molecules. Fractional factorial design (FFD), genetic algorithm (GA) and successive projection algorithm (SPA) were applied to select the most relevant 3 D molecular descriptors. The descriptors selected using various feature selection were correlated with skin permeability constants by partial least squares (PLS) and support vector machine (SVM). SPA-SVM model gave prominent statistical values with the correlation coefficient of [Formula: see text]= 0.96, Q2= 0.73 and R2pred=0.76. According to the analysis results, the hydrogen bonding donor and acceptor properties of the investigated compounds can influence the penetration into the human skin. Furthermore, it was found that permeability was enhanced by increasing the hydrophobicity and was diminished by increasing the molecular weight. In addition, the presence of hydrophobic groups in the target molecule, as well as their shape and position, can affect the skin permeability.


Assuntos
Substâncias Perigosas/química , Permeabilidade/efeitos dos fármacos , Relação Quantitativa Estrutura-Atividade , Pele/efeitos dos fármacos , Algoritmos , Química Computacional , Ecotoxicologia , Substâncias Perigosas/toxicidade , Humanos , Ligação de Hidrogênio/efeitos dos fármacos , Medição de Risco , Pele/química , Máquina de Vetores de Suporte
19.
J Environ Health Sci Eng ; 17(1): 493-502, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31297222

RESUMO

PURPOSE: This study aimed to investigate chemical composition of PM10 (particulate matter with aerodynamic diameter ≤ 10 µm) during dust storm and inversion in Tehran and hemolysis effects. METHODS: PM10 was sampled in Tehran, Iran, during dust storm and inversion conditions. Water soluble ions (F¯, Cl¯, NO2¯, NO3¯, SO4¯2, Na+, K+, NH4 +, Ca+2, Mg+2) and elements (Al, Ba, Cd, Co, Cr, Cu, Fe, Li, Mn, Mo, Ni, Pb, Se, Sn, Sr, V, Zn, Pt, Rh, Pd, As and Si) were analyzed by ion chromatograph (IC) and inductively coupled plasma optical emission spectrometer (ICP-OES), respectively. Hemolysis was examined as in vitro at PM10 concentrations of 50-300 µg/ml. RESULTS: Daily average of PM10 concentrations in dusty and inversion days were 348.40 and 220.54 µg/m3, respectively. Most prevalence ionic components were NO3¯, Cl¯, SO4¯2 and Ca+2 during dust storm and SO4¯2, NO3¯, Cl¯ and NH4 + during inversion. Si, Fe and Al had the maximum values in both conditions. Particles associated with both conditions induced hemolytic responses. PM10 from dusty day showed a higher hemolysis percent (10.24 ± 4.67%) than inversion (9.08 ± 5.47%), but this difference was not significant (p = 0.32). Hemolytic effects were significantly intensified by increased PM concentrations (p < 0.001) in a dose-response manner. CONCLUSIONS: As the results, chemical composition of sampled particles from inversion days and dust storm was different from each other. Hemolytic effects of particles during dust storm were more than inversion days. However, this difference was not statistically significant.

20.
J Environ Health Sci Eng ; 17(1): 433-444, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31321054

RESUMO

Particulate matter (PM) as the carcinogenic air pollutants can lead to aggravated health outcomes. Epidemiological studies demonstrated that PM can be engaged in different diseases such as cardiovascular, respiratory and cancer. The in vitro secretion of proinflammatory cytokines by human peripheral blood mononuclear cells (PBMCs) has been used to assess the effects of PM with an aerodynamic diameter < 10 µm (PM10). This study compared the proinflammatory cytokines tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6), and interleukin 1-beta (IL1-ß) secretions of PBMCs exposed to PM10 of dust storm and inversion. We collected PM10 samples during the spring and autumn seasons in two locations. Isolated PBMCs were exposed separately to 50, 150, and 300 µg/ml of different type of PM10 for 4 and 24 h. The mean concentrations of TNF-α for the PM of dust storm and inversion were 6305.61 ± 2421 and 6651.74 ± 2820, respectively. Also the mean concentrations of IL1-ß for the PM of dust storm and inversion were 556.86 ± 162 and 656.35 ± 196, respectively. Furthermore, these values for the production of IL-6 were 12,655 ± 5661 and 16,685 ± 8069, respectively. Although no significant difference was observed between the PM of dust storm and that of inversion with regard to PBMCs, the results showed a significant increase in the proinflammatory cytokine secretion of both PMs compared with the controls. Moreover, TNF-α, IL1-ß, and IL-6 secreted in cells exposed to PM10 of dust storm were about 10 times more than the controls, these values for cells exposed to PM10 of inversion were around 10, 12, and 14 times more than the controls, respectively. It can be concluded that the PM10 of both dust storm and inversion can play a significant role in proinflammatory cytokine secretion due to its harmful effect on human health. Graphical abstractThis picture shows the Proinflammatory cytokine producing potential of PM10 with two sources (dust storm and urban air pollution) in exposure with human PBMCs in vitro.

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