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One Anastomosis/Mini-Gastric Bypass (OAGB/MGB) as Revisional Surgery Following Primary Restrictive Bariatric Procedures: a Systematic Review and Meta-Analysis
Full text linkOne anastomosis gastric bypass (OAGB/MGB) has gained popularity in the past decade. International databases were searched for articles published by September 10, 2020, on OAGB/MGB as a revisional procedure after restrictive procedures. Twenty-six studies examining a total of 1771 patients were included. The mean initial BMI was 45.70 kg/m2, which decreased to 31.52, 31.40, and 30.54 kg/m2 at 1, 3, and 5-year follow-ups, respectively. Remission of type-2 diabetes mellitus (T2DM) following OAGB/MGB at 1-, 3-, and 5-year follow-up was 65.16 ± 24.43, 65.37 ± 36.07, and 78.10 ± 14.19, respectively. Remission/improvement rate from gastroesophageal reflux disease (GERD). Also, 7.4 of the patients developed de novo GERD following OAGB/MGB. Leakage was the most common major complication. OAGB/MGB appears to be feasible and effective as a revisional procedure after failed restrictive bariatric procedures. © 2020, The Author(s)
Identification of the Range of Nursing Skills Used to Provide Social Support for Mothers of Preterm Infants in Neonatal Intensive Care
Full text linkBackground. Hospitalization of preterm infants in neonatal intensive care units (NICUs) is a stressful experience for parents. Iranian NICUs do not have specified levels of care, nor do they integrate supportive methods of parent support such as family-centered care approaches. This study investigated the range and types of neonatal nursing support, as perceived by mothers of preterm infants, and its association with mothers' satisfaction with infant care in the NICU. Methods. This is a descriptive, correlational study of mothers of preterm infants who were hospitalized in three different NICUs in Iran. A convenience sampling method was used. Data were collected using three questionnaires that identified (i) demographic information; (ii) social support available; and (iii) parent satisfaction with infant care. Results. Mothers (N = 110) generally rated the support from nurses as being moderate. Correlation analysis identified a moderate association of neonatal nurse social support domains for affirmational (r = 0.44) and concrete aid (r = 0.41), a moderately strong association for affectional support (r = 0.64), and total social support (r = 0.60) with mothers' satisfaction. Conclusion. There were positive associations between social support from nurses and mothers' satisfaction with the care of their infants. Therefore, planning to promote and create opportunities for neonatal nurses to support mothers in NICU is important to promote increased maternal satisfaction in infant care. © 2021 Shadi Eskandari et al
Determination of investigation of the link between human and animal Brucella isolates in Iran using multiple-locus variable number tandem repeat method comprising 16 loci (MLVA-16)
Full text linkBackground: Epidemiological studies are important tools to assess the diversity of Brucella isolates and to estimate their epidemiological relationship among isolates from different geographical origins. In this study the MLVA16 (multiple-locus variable number tandem repeat analysis based on 16 loci) was employed to investigate the diversity of Brucella spp. Isolated from humans and animals for epidemiological purposes and to determine the most common Brucella genotypes in Iran. Methods: We designed a molecular-based study to evaluate the potential reservoirs of human brucellosis. After isolation and identification of 54 Brucella spp human and animal specimens from three regions of Iran, bacterial genomic DNA was extracted MLVA with three panel was used for the genotyping of isolates. The size of PCR products were analyzed and converted to repeat unit numbers using a published allele numbering system and data set was imported into Bionumerics. Results: Three isolates (5.55) were identified as Brucella abortus and 51 (94.44) as Brucella melitensis. Two isolates of Brucella abortus were from humans and one from an animal. Thirty-four Brucella melitensis isolates were from humans and 17 from animals. Using MLVA16-genotyping, 54 isolates with genetic similarity coefficient of 80 were divided into 46 genotypes and 22 genotypes were represented by a single isolate, while 4, 2, 1 and 2 genotypes were represented by 2, 3, 4 and 7 isolates, respectively. The most prevalent genotype was represented by 14 isolates. There were two other frequent genotypes each represented by seven isolates, among which only one was restricted to a geographic region. Discriminatory power for each locus was determined in this study and panel 2B shows the high discretionary power Bruce04 (0.837), Bruce30 (0.806), Bruce 09 (0.787), Bruce 07 (0.772), Bruce16 (0.766). Conclusion: MLVA16 analysis of 54 Brucella isolates showed high level polymorphism in their genotypes. Only two genotypes, each observed in seven isolates, were related to one another and only one of these genotypes were found in to two separate regions. © 202
Relationship between echogenicity of deep cervical muscles and pain laterality in subjects suffering from cervicogenic headache
No full textObjective: This study investigated the deep upper cervical muscles echogenicity in cervicogenic headache (CGH) patients. Methods: The echogenicity of longus capitis (LCAP), rectus capitis posterior major (RCPM), and obliquus capitis superior (OCS) muscles was measured by ultrasonography and analyzed by Image J software in 17 CGH patients matched with 17 healthy subjects. Results: The echogenicity of all muscles in the CGH group was higher than that in healthy subjects. The echogenicity of the LCAP muscle on the right side was significantly different between the CGH and healthy subjects (p 0.05). Additionally, the echogenicity differences did not match with the pain side in CGH patients (p> 0.05). Conclusion: Only the deep anterior muscle (LCAP) echogenicity affected by CGH and fatty infiltration occurred in this muscle. Hence, anterior muscle dysfunction is important in CGH diagnosis and treatment. © 2021 Taylor & Francis Group, LLC
Effect of expressive writing on promotion of body image in women with multiple sclerosis: A randomized controlled trial
Full text linkBackground and purpose: Multiple sclerosis (MS) affects own physical function and body image. The aim of this study was to determine the effect of expressive writing on body image in women with MS. Materials and methods: In this randomized trial, the Solomon four-group design was employed. The study was carried out in 116 women attending an MS clinic in Tehran, Iran 2019. The participants were randomly assigned to two subgroups of control (A1 and A2) and two subgroups of intervention (B2 and B1). Pretest and posttest were done in A2 and B2 while for A1 and B1only posttest was performed. Expressive writing including morning pages, meeting the inner child, and creative assignments were carried out for six weeks. The control group received routine care. Fisher Body Focus Questionnaire was completed at pretest in A2 and B2 and at posttest in all groups (immediately after the intervention, and at weeks four and eight). Data analysis was done in SPSS V26. Results: The mean scores for body image in B2 were 145.65±19.89 at pretest, 156.89±9.54 immediately after the intervention, 158.16±8.92 at week four, and 153.96±8.27 at week eight. In A2, the mean score at these times were 144.96±7.17, 145.55±5.10, 145.28±7.84, 145.00±9.15, respectively. Expressive writing significantly improved body image in B2 at immediately and four weeks after the intervention compared to pretest (P<0.001). There were significant differences between the control group and intervention group at immediately after (P=0.002) and four weeks (P=0.03) after the intervention. Conclusion: Expressive writing could be effective in improving body image in women with MS. © 2021, Mazandaran University of Medical Sciences. All rights reserved
Chronic nanocurcumin treatment ameliorates pain-related behavior, improves spatial memory, and reduces hippocampal levels of IL-1β and TNFα in the chronic constriction injury model of neuropathic pain
No full textBackground: Memory deficit is a common cognitive comorbid in patients with neuropathic pain that need better treatment. Recent research revealed that nanocurcumin has an antinociceptive action and a protective effect against memory disorders, suggesting its possible effectiveness for the treatment of neuropathic pain and its comorbidity. Methods: Adult male albino Wistar rats (n = 32) were randomly divided into four experimental groups: CCI+ nanocurcumin, CCI + vehicle, sham + nanocurcumin, and sham + vehicle. Neuropathic pain induced by a chronic constriction injury of the sciatic nerve. Nanocurcumin or vehicle was injected intraperitoneally for 10 days. Behavioral assessment achieved to evaluate pain threshold in the von Frey test and radiant heat test, also spatial learning and memory examined by the Morris water maze (MWM) test. To explore the possible relation, IL-1β, and TNF-α levels of the hippocampus measured by enzyme-linked immunosorbent assay (ELISA). Results: Our data showed that CCI caused neuropathic pain-related behaviors and spatial learning and memory disorders in rats. Chronic treatment with nanocurcumin significantly increased pain threshold (P < 0.001; F = 27.63, F = 20.58), improved spatial memory (P < 0.01; F = 47.37), and decreased the hippocampal levels of IL-1β (P < 0.001; F = 33.57) and TNF-α (P < 0.01; F = 7.25) in CCI rats. Conclusion: Chronic nanocurcumin can ameliorate pain-related behavior, improve spatial learning and memory deficits, and is associated with the reduction of IL-1β and TNF-α levels in the hippocampus in CCI rats. Nanocurcumin may be potentially providing a therapeutic alternative for the treatment of neuropathic pain and its memory impairment comorbidity. © 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature
A clinical trial of volume- versus pressure-controlled intraoperative ventilation during laparoscopic bariatric surgeries
No full textBackground: Intra-operative ventilation is often challenging in patients with morbid obesity undergoing bariatric surgery. Objectives: To test the noninferiority of pressure-controlled ventilation (PCV) to volume-controlled ventilation (VCV) in respiratory mechanics. Setting: Bariatric Surgery Center, Iran. Methods: In a randomized open-labeled clinical trial, 66 individuals with morbid obesity undergoing laparoscopic bariatric surgeries underwent intraoperative ventilation with either PCV or VCV. The measurements taken were peak and mean airway pressures (H2O), partial pressure of arterial oxygen (PaO2), partial pressure of arterial carbon dioxide (PaCO2) and end-tidal carbon dioxide (CO2). We additionally collected pulse-oximetric oxygen saturation, inspiratory concentration of oxygen (FiO2), and hemodynamic variables. Data were analyzed with repeated measures over the time of intubation, after peritoneal insufflation, and every 15 minutes, thereafter up to one hour. Results: PCV mode was successful to sustain adequate ventilation in 97 of the patients, which was similar to the 94 success rate of the VCV mode. Peak airway pressure increased 6 cmH2O and end-tidal CO2 rose by 5 mm Hg after abdominal insufflation in both groups (P = .850 and .376). Alveolar-arterial oxygen gradient similarly increased within 30 minutes after tracheal intubation both in PCV and VCV groups, with small trend of being higher in the VCV group. The ratio of dead space to tidal volumes (VD/VT) did not have a meaningful change (P = .724). Conclusion: PCV was noninferior to VCV during laparoscopic bariatric surgery. Either mode of ventilation could be alternatively used during the anesthesia care of these patients. © 2020 American Society for Bariatric Surger
Impaired cholesterol efflux capacity in patients with Helicobacter pylori infection and its relation with inflammation
No full textBackground: Gut microorganisms are associated with atherosclerosis and related cardiovascular disease. Helicobacter pylori (H. pylori) infection is associated with dyslipidemia and inflammation contributing to the progression of atherosclerosis. Objective: Several studies have reported reduced HDL-C levels in H. pylori infected patients, but HDL cholesterol efflux capacity (CEC) as the most important function of HDL has not been evaluated yet. Methods: This cross-sectional study was conducted with 44 biopsy confirmed H. pylori patients and 43 controls. ABCA1-mediated, non-ABCA1 and total CEC were measured in ApoB-depleted serum and levels of ApoA-I, ApoB and hsCRP were estimated using ELISA technique. Results: Total and ABCA1 mediated-CEC were reduced in patients compared to controls, independent of age, sex, body mass index and HDL-C (p < 0.001), while non-ABCA1 CEC indicated no significant change between the groups. In addition, patients showed lower serum levels of ApoA-I but increased levels of hsCRP when compared to controls. Total CEC and ABCA1-mediated CEC positively correlated with ApoA-I and HDL-C, furthermore, ABCA1-mediated CEC as well as ApoA-I inversely correlated with hsCRP. Conclusion: The results of the present study indicate reduced CECs in H. pylori infected patients, especially ABCA1-mediated CEC which is associated with decreased ApoA-I and increased inflammation. © 2020 National Lipid Associatio
Implementation of combinational deep learning algorithm for non-alcoholic fatty liver classification in ultrasound images
Full text linkBackground: Nowadays, fatty liver is one of the commonly occurred diseases for the liver which can be observed generally in obese patients. Final results from a vari-ety of exams and imaging methods can help to identify and evaluate people affected by this condition. Objective: The aim of this study is to present a combined algorithm based on neural networks for the classification of ultrasound �images from fatty liver affected patients. Material and Methods: In experimental research can be categorized as a diagnostic study which focuses on classification of the acquired ultrasonography images for 55 patients with fatty liver. We implemented pre-trained convolutional neural networks of Inception-ResNetv2, GoogleNet, AlexNet, and ResNet101 to extract features from the images and after combining these resulted features, we provided support vector machine (SVM) algorithm to classify the liver images. Then the results are compared with the ones in implementing the algorithms independently. Results: The area under the receiver operating characteristic curve (AUC) for the introduced combined network resulted in 0.9999, which is a better result compared to any of the other introduced algorithms. The resulted accuracy for the proposed network also caused 0.9864, which seems acceptable accuracy for clinical application. Conclusion: The proposed network can be used with high accuracy to classify ultrasound images of the liver to normal or fatty. The presented approach besides the high AUC in comparison with other methods have the independence of the method from the �user or expert interference. © 2021, Shriaz University of Medical Sciences. All rights reserved