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Intravascular Ultrasound for Assessment of Residual Coarctation of the Aorta after Balloon Angioplasty in Infants
Full text linkIntravascular ultrasound (IVUS) has been introduced as an accurate and minimally invasive diagnostic technique for the assessment of vascular anatomy and its abnormalities. We believe that IVUS can be used for clarifying the reasons for failure of balloon angiography in infantile coarctation of the aorta (CoA), because post-balloon angioplasty tearing, intimal flap, thrombosis and pseudoaneurysm of the aorta can be evaluated by IVUS with greater sensitivity and specificity. We aimed to assess the outcome of balloon angioplasty of CoA using angiography as the gold standard and IVUS as a new method in infants, comparing the two techniques for the evaluation of the diameter and area of CoA segment pre- and post-procedure. This cross-sectional study was performed on 18 infants hospitalized with a final diagnosis of CoA. All the infants underwent angiography and were also assessed by IVUS to measure the preoperative and postoperative diameter of the narrow segment in the two anterior�posterior and lateral views. In assessment by IVUS, the mean diameter of the coarctation site increased from 2.10 ± 0.30 mm to 4.50 ± 0.94 mm (P < 0.001). Similarly, the average minimum area of the coarctation level increased from 5.26 ± 1.50 mm2 to 13.77 ± 3.48 mm2 after angioplasty (P < 0.001). Comparing these findings, angiography and IVUS showed a high level of agreement. In the assessment of a dissection flap, there was a high level of agreement between angioplasty and IVUS before the procedure, but IVUS had higher accuracy after the procedure. Our study showed that IVUS was more reliable than angiography in the assessment of residual coarctation. IVUS yielded high sensitivity (58.3) and specificity (100) for discriminating the presence and absence of residual coarctation as well as the need for repeating the procedure. The assessment of coarctation before and after angioplasty procedures in children is possible using the IVUS method, with high accuracy. IVUS can offer greater accuracy than angiography in the evaluation of the coarctation area, detecting tears, dissection and flaps, and assessment of residual coarctation. © 2021, Springer Science+Business Media, LLC, part of Springer Nature
Administration of intravenous immunoglobulin in the treatment of COVID-19: A review of available evidence
No full textSince December 31, 2019, unknown causes of pneumonia have been reported in Wuhan, China. This special pneumonia associated with a novel coronavirus was named 2019-nCoV by the World Health Organization (WHO) in January 2020. From the beginning of this infectious disease, clinicians and researchers have been endeavoring to discover an effective and suitable treatment for affected patients. To date, there is no definitive and specific treatments for coronavirus disease-19 (COVID-19) infection while drugs introduced are still in the clinical trial phase. Intravenous immune globulin (IVIG) is a biological product prepared from the serum and an optional treatment for patients with antibody deficiencies. In many countries, much attention has been paid to the use of IVIG in the treatment of patients with COVID-19. Due to the therapeutic importance of IVIG in virus infections, in the current study, we reviewed the possible effect of IVIG in viral infections and potential evidence of IVIG therapy in patients with COVID-19 virus. © 2020 Wiley Periodicals LL
A multiple multilayer perceptron neural network with an adaptive learning algorithm for thyroid disease diagnosis in the internet of medical things
No full textMedical information systems such as Internet of Medical Things (IoMT) are gained special attention over recent years. X-ray and MRI images are important sources of information to be examined for a particular type of anomalies. Reports based on the images and laboratory examination results could be mined with machine learning techniques as well. Thyroid disease diagnosis is an important capability of medical information systems. The main objective of this study is to improve the diagnosis accuracy of thyroid diseases from semantic reports and examination results using artificial neural network (ANN) in IoMT systems. In order to improve generalization and avoid over-fitting of ANN during the training process, a set of multiple multilayer perceptron (MMLP) neural network with the back-propagation error ability is proposed in this paper. Moreover, an adaptive learning rate algorithm is used to deal with the slow convergence and the local minima problem of the back-propagation error algorithm. The proposed MMLP significantly increased the overall accuracy of thyroid disease classification. With MMLP with a set of 6 networks, an improvement of 0.7 accuracy is achieved compared to a single network. In addition, comparing to the standard back-propagation, by using an adaptive learning rate algorithm in the proposed MMLP, an improvement of 4.6 accuracy and the final accuracy of 99 have been obtained in IoMT systems. The proposed MMLP is compared to recent researches reported for thyroid disease diagnosis, and its superiority is shown. © 2020, Springer Science+Business Media, LLC, part of Springer Nature
A review on phytochemical and therapeutic potential of Iris germanica
Full text linkOBJECTIVES: Iris germanica L. is a medicinal plant, which has a long history of uses, mainly in medieval Persia and many places worldwide for the management of a wide variety of diseases. In this study, we aimed to review ethnopharmacological applications in addition to phytochemical and pharmacological properties of I. germanica. KEY FINDINGS: Ethnomedical uses of I. germanica have been reported from many countries such as China, Pakistan, India, Iran and Turkey. The medicinal part of I. germanica is the rhizome and the roots. Based on phytochemical investigations, different bioactive compounds, including flavonoids, triterpenes, sterols, phenolics, ceramides and benzoquinones, have been identified in its medicinal parts. Current pharmacological studies represent that the plant possesses several biological and therapeutic effects, including neuroprotective, hypoglycaemic, hypolipidaemic, antimicrobial, antioxidant, antiproliferative, anti-inflammatory, antiplasmodial, antifungal, immunomodulatory, cytotoxic and antimutagenic effects. SUMMARY: Although the majority of preclinical studies reported various pharmacological activities of this plant, however, sufficient clinical trials are not currently available. Therefore, to draw a definitive conclusion about the efficacy and therapeutic activities of I. germanica and its bioactive compounds, further clinical and experimental studies are required. Moreover, it is necessary to focus on the pharmacokinetic and safety studies on the extracts of I. germanica. © The Author(s) 2021. Published by Oxford University Press on behalf of the Royal Pharmaceutical Society. All rights reserved. For permissions, please e-mail: [email protected]
Vitamin D3 Controls TLR4- A nd TLR2-Mediated Inflammatory Responses of Endometrial Cells
Full text linkObjectives: Vitamin D has potent immunoregulatory features and modulates innate and adaptive immune responses. There is a significant association between intrauterine infection-associated inflammatory responses and pregnancy complications such as abortion and preterm labor. Here, we investigated how 1,25 (OH)2 D3 could modulate inflammatory responses of endometrial cells. Design: This is an in vitro experimental study. Endometrial stromal cells (ESCs) and whole endometrial cells (WECs) were collected from 15 apparently normal women, and the immunomodulatory effects of 1,25 (OH)2 D3 on lipopolysaccharide (LPS)-or lipoteichoic acid (LTA)-treated ESCs and WECs were investigated. Participants/Materials, Setting, and Methods: Women with no history of abortion, infertility, endometriosis, or sign of vaginal infection were enrolled in this study. Endometrial samples were collected by gynecologists using a Pipelle pipette in the proliferative phase of the menstrual cycle. WECs and ESCs were collected and treated with either LPS or LTA. The levels of IL-6, IL-8, and TNF-α in culture supernatants were quantified using the ELISA technique. TLR2, TLR4, and MyD88 expressions were assessed by RT-qPCR. TLR4 expression at the protein level was studied by the Western blot technique. Results: 1,25 Dihydroxycholecalciferol (1,25 (OH)2 D3) significantly reduced TNF-α production in LPS-activated ESCs and TNF-α and IL-6 production by LTA-stimulated WECs. In contrast, 1,25 (OH)2 D3 pretreatment increased the production of IL-8 by LPS- A nd LTA-stimulated endometrial cells. 1,25 (OH)2 D3 pretreatment markedly reduced LPS-induced TLR4 protein expression by ESCs. LPS treatment of ESCs significantly induced MyD88 gene expression. This effect was reversed when these cells were pretreated with 1,25 (OH)2 D3 before stimulation with LPS. Limitations: Because of the small size of samples, doing experiments all together on some samples was not feasible. Confirmation of the results obtained here needs well-designed in vivo studies. Conclusions: 1,25 (OH)2 D3 is an immunomodulatory molecule essential for maintaining endometrial immune homeostasis by controlling potentially harmful inflammatory responses associated with female reproductive tract infections. © 202
The effects of Chlorella supplementation on glycemic control, lipid profile and anthropometric measures on patients with type 2 diabetes mellitus
No full textBackground: Diabetes is a chronic disease and the prevalence of it is rapidly increasing. Recently, the use of natural products in chronic diseases such as diabetes has gained more attention. Chlorella, a single-celled green alga, is one of them. There have been some studies on the effects of chlorella supplementation in chronic diseases such as NAFLD, prediabetes, and diabetic mice, but none of them examined the effects of chlorella in patients with T2DM. The present study was designed to evaluate the effects of chlorella supplementation on glycemic control, lipid profile, and anthropometric indices in type 2 diabetic patients. Methods: This study is a double-blind, randomized controlled trial. 84 patients with T2DM assigned into two groups, receiving 1500 mg/day C. vulgaris or placebo for 8 weeks. Anthropometric information, blood pressure, 24-h food intake recall, and blood samples were collected at the beginning and end of the study to determine the changes of FBS, HbA1c, insulin concentration, insulin resistance, and lipid profile. Results: None of the variables investigated in this study showed a significant change after 8 weeks of intervention with C. vulgaris. Conclusion: According to the findings of this study, supplementation with C. vulgaris with a dosage of 1500 mg/day for 8 weeks, does not improve the anthropometric measurements, glycemic status, and lipid profile as well. Thus, it cannot be considered as a complementary therapeutic approach to common medications at this dosage and duration. However, future studies with a higher dosage of C. vulgaris and more prolonged than 8 weeks are needed to be done. © 2021, Springer-Verlag GmbH, DE part of Springer Nature
Ultrahigh-water-content biocompatible gelatin-based hydrogels: Toughened through micro-sized dissipative morphology as an effective strategy
No full textFabrication of simultaneously robust and superabsorbent gelatin-based hydrogels for biomedical applications still remains a challenge due to lack of locally dissipative points in the presence of large water content. Here, we apply a synthesis strategy through which water absorbency and energy dissipative points are separated, and toughening mechanism is active closely at the crack tip. For this, gelatin-based microgels (GeMs) were synthesized in a way that concentrated supramolecular interactions were present to increase the energy necessary to propagate a macroscopic crack. The microgels were interlocked to each other via both temporary hydrophobic associations and permanent covalent crosslinks, in which the sacrificial binds sustained the toughness due to the mobility of the junction zones and particles sliding. However, chemical crosslinking points preserved the integrity and fast recoverability of the hydrogel. Hysteresis increased strongly with increasing supramolecular interactions within the network. The prepared hydrogels showed energy loss and swelling ratio up to 3440 J. m�3 and 830, respectively, which was not achievable with conventional network fabrication methods. The microgels were also assessed for their in vivo biocompatibility in a rat subcutaneous pocket assay. Results of hematoxylin and eosin (H&E) staining demonstrated regeneration of the tissue around the scaffolds without incorporation of growth factors. Also, vascularization within the scaffolds was observed after 4 weeks implantation. These results indicate that our strategy is a promising method to manipulate those valuable polymers, which lose their toughness and applicability with increasing their water content. © 202
Dysentery as a rare GI symptom found in COVID-19 patients La disenterÃa como sÃntoma digestivo poco frecuente que se encuentra en los pacientes con COVID-19
Full text linkThe effects of anticancer medicinal herbs on vascular endothelial growth factor based on pharmacological aspects: a review study
No full textAs a complicated process of forming new blood vessels from the present vasculature endothelium, angiogenesis plays a critical role in the progression of cancer, through developing new blood vessels in tumor cells. Angiogenesis is regulated by proteins known as inhibitor or activator molecules, affected by different medicinal herbs and small molecules. In the present review, the molecular mechanisms of tumor angiogenesis are outlined, focusing on the pharmacological aspects and molecular mechanisms of natural compounds used in chemotherapy and their effects on angiogenesis, focusing on vascular endothelial growth factor (VEGF). Our findings show that a significant number of drugs used in the treatment of cancer are antiangiogenic small molecules and phytochemicals which inhibit VEGF and angiogenesis. Besides, medicinal herbs are potential multi-target agents with more covering mechanisms, lower costs and lower toxicity to develop novel anticancer drugs through targeting the VEGF signaling pathway and receptor tyrosine kinases (RTKs) in the angiogenesis. For this reason, herbal anti-VEGF agents are considered as imperative targets to be used for cancer treatment in clinical applications. The findings reveal a promising perspective for medicinal herbs and natural compounds acting on VEGF and angiogenesis to find new targets and potential therapeutic use in the treatment of cancer. © 2019 Taylor & Francis Group, LLC
Perceived Barriers to Implementing Sexual Health Programs from the Viewpoint of Health Policymakers in Iran: A Qualitative Study
No full textIntroduction: Despite the fact that sexual and reproductive health has been considered key aspects of the individual�s wellbeing and social welfare, there are no adequate policies and programs to deal with sexual health, particularly among young people. Methods: A qualitative study was conducted from February to December 2015. Twenty-five semi-structured in-depth interviews were conducted with health policymakers in Iran using a purposive sampling method. The qualitative data were analyzed using conventional content analysis with an inductive interpretive approach. Results: The perceived barriers for sexual health programs generated by health-policymakers reside in three main domains: individual, structural, and socio-cultural. Under the domain of individual, the category of policymakers� personal barriers comprises: �lack of knowledge,� �misperceptions,� and �stigma,� i.e., threat to their managerial positions. Under the domain of structural barriers, the category of �challenges in policy making processes� comprises: �the abstinence challenge/paradox of sexual health as a strategic goal,� �financial challenges,� �uncoordinated and unstable management of the program,� �challenges for data collection and planning,� and �lack of priority for sexual health.� Finally, under the domain of socio-cultural, the category of �conservative socio-cultural context, sexuality as a social taboo in Iranian society� emerged as a barrier for sexual health programs in Iran. Conclusions: To introduce sexual health programs in a conservative society, health-policymakers must begin by advocating for sexual health, in order to create positive attitudes toward sexual heath as a component of human wellbeing, and then address social and cultural sensitivities by promoting greater dialogue. Social and Public Policy Implications: Sexual health and sexual health needs are important aspects of life and warrant further research in Iran. Policy makers of the health system need to correct information of sexual health needs of people to health planning, and this clears barriers of sexual health planning in the health system of Iran. © 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature