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Cost-effectiveness analysis of mitral valve repair with the MitraClip delivery system for patients with mitral regurgitation: a systematic review
No full textTo assess the cost-effectiveness of mitral valve repair with the MitraClip delivery system for patients with mitral regurgitation and heart failure, a systematic literature search was conducted in various electronic databases to January 3, 2020. Eligibility criteria are the population (patients with mitral regurgitation (MR)), intervention (transcatheter mitral valve repair using the MitraClip), comparator (conventional medical treatment), outcomes, and designs (Model-based or trial-based full economic evaluations).The quality of included studies was assessed using the CHEERS checklist. Mortality and survival rate, quality-adjusted life year (QALY), life years gained (LYG), total cost, and the incremental cost-effectiveness ratio (ICER) regarding the use of MitraClip System were considered as the key outcomes. Eight articles were eligible for full-text assessment. Ultimately, a total of seven studies were considered in the current systematic review. Results demonstrated that MitraClip reduces mortality rate and increases survival rate. The mortality rate at 1 year and 10 years was 16.7 versus 29.77 and 70.9 versus 98.8, respectively. Total cost data based on 2019 USD show that the MitraClip has the highest cost in the USA (121,390) and the lowest cost in Italy (33,062). The results showed that in all selected countries, willingness-to-pay (WTP) thresholds are upper than the cost per QALY; also, the highest ICER for the MitraClip is in the USA (55,600/QALY) and the lowest in Italy (10,616/QALY). To conclude, evidence from this systematic review suggests that MitraClip Delivery System improved both life expectancy and QALY compared with medical treatment in patients at high surgical risk and it was also a cost-effective treatment option for patients with mitral regurgitation. © 2020, Springer Science+Business Media, LLC, part of Springer Nature
Occurrence, spatial distribution, seasonal variations, potential sources, and inhalation-based health risk assessment of organic/inorganic pollutants in ambient air of Tehran
Get PDFThe present study evaluated the concentrations, spatial distribution, seasonal variations, potential sources, and risk assessment of organic/inorganic pollutants in ambient air of Tehran city. Totally, 180 air samples were taken from 9 sampling stations from March 2018 to March 2019 and were analyzed to determine the concentrations of organic pollutants (BTEX compounds and PM2.5-bound PAHs) plus inorganic pollutants (PM2.5-bound metals and asbestos fibers). The results revealed that the mean concentrations of � PAHs, BTEX, � heavy metals, and asbestos fibers were 5.34 ng/m3, 60.55 µg/m3, 8585.12 ng/m3, and 4.13 fiber/ml in the cold season, respectively, and 3.88 ng/m3, 33.86 µg/m3, 5682.61 ng/m3, and 3.21 fiber/ml in the warm season, respectively. Source apportionment of emission of the air pollutants showed that PAHs are emitted from diesel vehicles and industrial activities. BTEX and asbestos are also released mainly by vehicles. The results of the inhalation-based risk assessment indicated that the carcinogenic risk of PAHs, BTEX, and asbestos exceeded the recommended limit by The US environmental protection agency (US EPA) and WHO (1 � 10�4). The risk of carcinogenesis of heavy metal of lead and chromium also exceeded the recommended limit. Thus, proper management strategies are required to control the concentration of these pollutants in Tehran's ambient air in order to maintain the health of Tehran�s citizens. © 2020, Springer Nature B.V
Ultrasensitive and easily reproducible biosensor based on novel doped MoS2 nanowires field-effect transistor in label-free approach for detection of hepatitis B virus in blood serum
No full textAn ultrasensitive field-effect transistor (FET) for hepatitis B virus deoxyribonucleic acid (HBV DNA) detection in label free approach and easily reproducible setup was reported. The fabricated FET biosensor was materialized by ZnO doped MoS2 nanowires (NWs). This report introduced a novel structure of the MoS2 in bio-sensing approach. Because of unique electrical and structural properties of MoS2, HBV biosensor could demonstrate the high sensitivity and showed the detection limit of 1 fM. The MoS2 NWs fabrication was materialized through ZnO based vapor-liquid-solid (VLS) technique. The fabricated device could measure the DNA targets in a linear concentration range from 0.5 pM to 50 μM. The dynamic response time of FET biosensor was 25 s. The functionality of the NWs biosensor for label-free measurements could be repeated for several times without any significant malfunction and biosensor could retain 96 of its initial response after eight weeks maintenance. The HBV biosensor showed high selectivity by discrimination the complementary DNA oligonucleotides from non-complementary and the mismatch (1, 2 and 3 bases) oligonucleotides. The materialized platform was desirably reproduced for HBV concentrations in human serum. The specificity of the biosensor was evaluated against several different types of DNAs and the fabricated device showed the outstanding performance. In order to optimize the device functionality, the biosensor was checked for two different human samples and device could distinguish the samples from each other in the same manner. © 2021 Elsevier B.V
In vivo study of interferon-?, transforming growth factor-�, and interleukin-4 gene expression induced by radioadaptive response
Get PDFIntroduction: In the present study, the radioadaptive role of the immune system induced by low dose (LD) was investigated for its in vivo protective activity. Materials and Methods: Quantitative analysis of cytokine gene expression was assessed for their in vivo activity in BALB/c mice. To evaluate the adaptive response induced by LD on the mice spleen lymphocyte, the cytokine interleukin (IL)-4, interferon (IFN)-?, and transforming growth factor (TGF)-� expression was measured by a real-time quantitative polymerase chain reaction. To verify the radioadaptive effect of LD, animals were preirradiated at 10 cGy from a 60 Co source and then challenge dose at 200 cGy was delivered. Independent sample student's t-test was employed to compare cytokine gene expression in radioadaptive (10 + 200 cGy), LD (10 cGy), high-dose (HD, 200 cGy), and control groups of animals. Results: Following the HD, the cytokine gene expression of IFN-?, IL-4, and TGF-� was significantly decreased compared to the control group (P = 0.0001). However, TGF-� expression was also decreased significantly in the LD and adaptive groups compared to the control group (P = 0.0001). IFN-?/IL-4 ratio in the adaptive group was significantly decreased compared to the HD group (P = 0.0001). Conclusion: These results indicate that the immune system plays an important role for radioadaptive response induction by LD radiation to adjust the harmful effects of HD irradiation. © 2021 Journal of Cancer Research and Therapeutics | Published by Wolters Kluwer-Medknow
Comparison of ultrasound-guided supra-scapular plus Axillary nerve block with Interscalene block for postoperative pain management in arthroscopic shoulder surgery; a double-blinded randomized open-label clinical trial
Get PDFBackground: Post-arthroscopic shoulder surgery pain is severe enough to interfere with initial recovery and rehabilitation. Objectives:We aimed to evaluate the analgesic effects of postoperative ultrasound-guided suprascapular plus axillary nerve blocks superficial subepidermal axon bundles (SSAB) with interscalene block (ISB) in arthroscopic shoulder surgery. Methods: In this single-blind randomized, open-label clinical trial, 80 candidates of elective arthroscopic shoulder surgery were randomly allocated to receive either SSAB or ISB at a postoperative care unit. The severity of resting and changing position pain was measured using visual analogue scale (VAS) score at 4h, 8h, 12h, 16h, and 24h, postoperatively. Timing of first opioid request, 24h dose requirement, patients� satisfaction rate, and side effects were also recorded. All registered data were analyzed using SPSS software version 23 for Windows (SPSS, Chicago, IL). Results: Resting and changing position pain scores were comparable between SSAB and ISB groups in the most time intervals. At 12h, moving and resting pain was significantly lower in ISB than SSAB group, while moving pain was more severe in ISB group at 24h assessment. Patient satisfaction scores were comparable between the two groups except for 12h assessment. Time to first analgesic requirement and total dose of 24h opioid requirement were not significantly different between the two groups. Conclusions: Suprascapular plus axillary nerve block could be an effective and safe alternative for interscalene block for pain management after arthroscopic shoulder surgery. © 2021, Author(s)
Spatial analysis of Toxocara spp. eggs in soil as a potential for serious human infection
No full textToxocara spp. cause one of the most widespread soil-transmitted helminthic infections worldwide. In both developed and developing countries, soil contamination with Toxocara eggs is considered as a major threat to public health. A total of 515 soil samples from 89 sampling sites were collected from different locations of public health such as Wastelands and Streets, public parks, and marginal areas. The soil samples were examined for Toxocara eggs using a centrifugal-floatation technique utilizing a saturated sodium nitrate solution. centralization of positive soil samples in the province was studied by Spatial Statistics Techniques such as Average Nearest Neighbors and Spatial Autocorrelation and Kernel Density Function Toxocara spp. eggs were found in 94 (18.25 ) out of 515 samples collected from the studied areas. According to the results obtained, marginal areas are often contaminated with eggs of Toxocara. Consequently, preventive measures including health education should be implemented to reduce the potential risk of this parasitic infection. © 2021 Elsevier Lt
The effectiveness of continuous and interval exercise preconditioning against chronic unpredictable stress: Involvement of hippocampal PGC-1α/FNDC5/BDNF pathway
No full textVarious exercise-training types are known to prevent depression, but mechanisms underlying their beneficial effects remain unknown. In the present study, the preconditioning effect of continuous and interval exercise on stress-induced depression was evaluated. Adult male Wistar rats in the exercise groups were made to run on a motorized treadmill, five sessions per week for six weeks. After that, to induce the depression model, the rats were exposed to chronic unpredictable stress for three weeks. Behavioral tests were assessed by open field, elevated plus maze, and forced swim tests. Hippocampal PGC-1α, FNDC5, and BDNF protein expression by Western blot and serum corticosterone by ELISA were detected. In the present results, after continuous and interval exercise periods, locomotor activity, the number of entries and time spent in the open arms were increased, and immobility time was significantly reduced. PGC-1α, FNDC5, and BDNF protein levels had a significant increase, and serum corticosterone did not change. Also, interval exercise training increased PGC-1α and FNDC5 more than continuous. Chronic unpredictable stress reduced the positive changes caused by exercise training, although, except FNDC5, exercise preconditioned groups experienced less significant adverse changes in most variables. These findings showed that both continuous and interval exercise preconditioning with increasing hippocampal PGC-1α, FNDC5, and BDNF proteins and improve the anxiety- and depression-like behaviors have a protective effect against chronic unpredictable stress. © 2021 Elsevier Lt
COVID-19 associated central nervous system manifestations, mental and neurological symptoms: A systematic review and meta-analysis
Get PDFThe ongoing pandemic of Coronavirus disease 2019 (COVID-19) has infected more than 27 million confirmed cases and 8,90,000 deaths all around the world. Verity of viral infections can infect the nervous system; these viral infections can present a wide range of manifestation. The aim of the current study was to systematically review the COVID-19 associated central nervous system manifestations, mental and neurological symptoms. For that we conducted a comprehensive systematic literature review of four online databases, including Web of Science, PubMed, Scopus and Embase. All relevant articles that reported psychiatric/psychological symptoms or disorders in COVID-19 without considering time and language restrictions were assessed. All the study procedures were performed based on the PRISMA criteria. Due to the screening, 14 studies were included. The current study result indicated that, the pooled prevalence of CNS or mental associated disorders with 95 CI was 50.68 (6.68-93.88). The most prevalence symptoms were hyposmia/anosmia/olfactory dysfunction (number of study: 10) with 36.20 (14.99-60.51). Only one study reported numbness/paresthesia and dysphonia. Pooled prevalence of numbness/paresthesia and dysphonia was 5.83 (2.17-12.25) and 2.39 (10.75-14.22). The pooled prevalence of depression and anxiety was 3.52 (2.62-4.54) and 13.92 (9.44-19.08). Our findings demonstrate that COVID-19 has a certain relation with neurological symptoms. The hypsomia, anosmia or olfactory dysfunction was most frequent symptom. Other symptoms were headache or dizziness, dysgeusia or ageusia, dysphonia and fatigue. Depression, anxiety, and confusion were less frequent symptoms. © 2020 Walter de Gruyter GmbH, Berlin/Boston 2020
SARS-CoV-2 antibody seroprevalence in the general population and high-risk occupational groups across 18 cities in Iran: a population-based cross-sectional study
Get PDFBackground: Rapid increases in cases of COVID-19 were observed in multiple cities in Iran towards the start of the pandemic. However, the true infection rate remains unknown. We aimed to assess the seroprevalence of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 18 cities of Iran as an indicator of the infection rate. Methods: In this population-based cross-sectional study, we randomly selected and invited study participants from the general population (from lists of people registered with the Iranian electronic health record system or health-care centres) and a high-risk population of individuals likely to have close social contact with SARS-CoV-2-infected individuals through their occupation (from employee lists provided by relevant agencies or companies, such as supermarket chains) across 18 cities in 17 Iranian provinces. Participants were asked questions on their demographic characteristics, medical history, recent COVID-19-related symptoms, and COVID-19-related exposures. Iran Food and Drug Administration-approved Pishtaz Teb SARS-CoV-2 ELISA kits were used to detect SARS-CoV-2-specific IgG and IgM antibodies in blood samples from participants. Seroprevalence was estimated on the basis of ELISA test results and adjusted for population weighting (by age, sex, and city population size) and test performance (according to our independent validation of sensitivity and specificity). Findings: From 9181 individuals who were initially contacted between April 17 and June 2, 2020, 243 individuals refused to provide blood samples and 36 did not provide demographic information and were excluded from the analysis. Among the 8902 individuals included in the analysis, 5372 had occupations with a high risk of exposure to SARS-CoV-2 and 3530 were recruited from the general population. The overall population weight-adjusted and test performance-adjusted prevalence of antibody seropositivity in the general population was 17·1 (95 CI 14·6�19·5), implying that 4 265 542 (95 CI 3 659 043�4 887 078) individuals from the 18 cities included were infected by the end of April, 2020. The adjusted seroprevalence of SARS-CoV-2-specific antibodies varied greatly by city, with the highest estimates found in Rasht (72·6 53·9�92·8) and Qom (58·5% 37·2�83·9). The overall population weight-adjusted and test performance-adjusted seroprevalence in the high-risk population was 20·0% (18·5�21·7) and showed little variation between the occupations included. Interpretations: Seroprevalence is likely to be much higher than the reported prevalence of COVID-19 based on confirmed COVID-19 cases in Iran. Despite high seroprevalence in a few cities, a large proportion of the population is still uninfected. The potential shortcomings of current public health policies should therefore be identified to prevent future epidemic waves in Iran. Funding: Iranian Ministry of Health and Medical Education. Translation: For the Farsi translation of the abstract see Supplementary Materials section. © 2021 Elsevier Lt
The effects of quinoa seed supplementation on cardiovascular risk factors: A systematic review and meta-analysis of controlled clinical trials
No full textThis meta-analysis was designed to determine the effect of quinoa seed on cardiovascular disease (CVD) risk factors in adults. PubMed, Scopus, ISI Web of Science, and Cochrane library were searched electronically from their inception to February 2020 to identify eligible RCTs. We calculated the pooled estimates of weighted mean differences (WMDs) and their 95 confidence intervals (CIs) by using random-effects models. Five eligible RCTs representing 206 subjects were enrolled. The pooled result showed that quinoa seed supplementation significantly lowered the body weight (WMD: �1.26 kg, 95 CI: �2.35, �0.18, p =.02), waist circumference (WC) (WMD: �1.15 cm, 95 CI: �2.08, �0.21, p =.01), fat mass (FM) (WMD: �0.59, 95 CI: �1.14, �0.03, p =.03), insulin serum level (WMD: �0.86 pmol/L, 95 CI: �13.38, �1.59, p =.01), triglyceride (TG) (WMD: �7.20 mg/dl, 95 CI: �9.52, �4.87, p .05). The current evidence suggests that quinoa seed might be utilized as a possible new effective and safe supplementary option to better prevent and control CVD in humans. © 2020 John Wiley & Sons Lt