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The association of disease type, pre-transplant hemoglobin level and platelet count with transfusion requirement after autologous hematopoietic stem cell transplantation
No full textBackground: Autologous hematopoietic stem cell transplantation (auto-HSCT) has become an effective treatment for a wide range of hematologic and non-hematologic diseases. Patients undergoing HSCT might require multiple platelets and red blood cell (RBC) transfusions during aplasia phase until engraftment, which could profoundly affect patients' conditions. Identification of risk factors associated with blood product requirements could help in decreasing transfusion-related complications. We evaluated the association of disease type, pre-transplant hemoglobin level, and pre-transplant platelet count with RBC/platelet transfusion requirement after auto-HSCT. Methods: In this retrospective study, 324 patients diagnosed with multiple myeloma (MM), Hodgkin disease (HD), and non-Hodgkin lymphoma (NHL) and underwent auto-HSCT were included. The associations of disease type, pre-transplant hemoglobin level, and platelet count with post-transplant packed cell and single-/random-donor platelet transfusions were evaluated. Results: Our study results illustrated that the higher pre-transplant hemoglobin level significantly decreased the post-HSCT requirement for packed cell (IRR=0.81, CI: 9.73- 0.90, P=0.0001), while the pre-transplant platelet showed no significant relationship with platelet requirement after HSCT. HD was associated with increment in packed cell (IRR=2.04, CI: 1.35-3.08, P=0.001) and single donor platelet (IRR=1.39, CI: 1.09-1.78, P=0.008) requirement after transplant. The trends showed that a higher platelet level led to a lower need for platelet transfusion. Conclusion: Pre-transplant hemoglobin level could be valuable markers for predicting post- HSCT RBC requirements and might be beneficial for better management of transfusion requirements to minimize the transfusion-related complications. Patients with HD seem to be more prone to blood product requirements post-transplant. © 2021 Babol University of Medical Sciences. All rights reserved
Association between cardiometabolic risk factors and COVID-19 susceptibility, severity and mortality: a review
No full textThe novel coronavirus, which began spreading from China Wuhan and gradually spreaded to most countries, led to the announcement by the World Health Organization on March 11, 2020, as a new pandemic. The most important point presented by the World Health Organization about this disease is to better understand the risk factors that exacerbate the course of the disease and worsen its prognosis. Due to the high majority of cardio metabolic risk factors like obesity, hypertension, diabetes, and dyslipidemia among the population over 60 years old and higher, these cardio metabolic risk factors along with the age of these people could worsen the prognosis of the coronavirus disease of 2019 (COVID-19) and its mortality. In this study, we aimed to review the articles from the beginning of the pandemic on the impression of cardio metabolic risk factors on COVID-19 and the effectiveness of COVID-19 on how to manage these diseases. All the factors studied in this article, including hypertension, diabetes mellitus, dyslipidemia, and obesity exacerbate the course of Covid-19 disease by different mechanisms, and the inflammatory process caused by coronavirus can also create a vicious cycle in controlling these diseases for patients. © 2021, Springer Nature Switzerland AG
Simultaneous detection of bovine rotavirus (Brv) and bovine viral diarrhea (bvd) virus in diarrheic stool samples: A comparative study of molecular and serological approaches
No full textBackground: Calf scours (diarrhea) in unweaned calves play a major role in economic losses of animal farming industry worldwide. The present study was conducted to investigate and interpret the presence of BRV, BVDV, and Escherichia coli K99 by molecular and serological approaches simultaneously. Materials & Methods: A total of 73 E. coli-negative diarrheic fecal samples were collected from one-week to less than one-month-old calves of Holstein dairy cattle herds of some provinces of Iran during autumn and winter. The samples were directed to antigen detection by ELISA (Enzyme Linked ImmunoSorbent Assay), RNA extraction by semi-manual approach, and cDNA synthesis for PCR amplification. Findings: Out of 73 calves� diarrheic fecal samples, 28 (38.3) and 1 (1.36) were positive for BRV and BVDR by ELISA, respectively. However, 31 (42.4) samples were positive for BRV and non for BVDV by RT-PCR. The Kappa coefficient showed significant differences in BRV and BVDR detection between ELISA and RT-PCR methods. The distribution of the BRV-positive samples among bovine diarrheic calves was 80, 52.6, and 50 in Eslamshahr, Qazvin, and Hamedan, respectively. Conclusion: ELISA and RT-PCR indicated high prevalence rate of BRV in autumn and winter, respectively. The present study results showed that positive cases detected by RT-PCR were more than those detected by ELISA. Further studies are needed to achieve a comprehensive preventive and therapeutic strategy to address diarrhea bovine pathogens. © 2021, TMU Press
Being torn by inevitable moral dilemma: experiences of ICU nurses
No full textBackground: Ethical decision-making of nurses could affect patients� recovery and also decrease medical costs. To make ethical decisions, ICU nurses experience complicated ethical conflicts. Considering the multi-dimensional process of ethical decision-making, the present study was conducted to describe the experiences of ICU nurses regarding ethical decision making. Method: The present research is a qualitative study with conventional content analysis approach that was done in 2020. Fourteen ICU nurses were interviewed using a semi-structured in-depth interview method. The interviews were recorded, transcribed verbatim, and analyzed using Granheim and Landman approach. Results: Being torn by inevitable moral dilemma was defined as the main category which contained the categories of conflict with professional self, feeling squeezed between self-authority and demands of others, and Surrounded by organizational limitations. Conclusions: Results of the present study showed that moral dilemma is a situation in which the nurses are forced to choose between two options based on their equipment and facilities. In these situations, the nurses would hesitate between their internal conflicts and confusion between choosing their own benefits and patients� benefits. To prevent ethical challenges in decision making, it is necessary to educate healthcare team about ethical dilemmas and empower the personnel for encountering ethical challenges. © 2021, The Author(s)
Role of frailty in prediction of hospitalized older adult patient�s outcomes: A prospective study
No full textBackground/aim: Frailty is associated with an increased risk of negative short-term and long-term hospital outcomes. This study aimto evaluate the role of frailty in predicting readmission, length of stay, and quality of life in the hospitalized older adults. Materials and methods: This observational study was conducted at Ziaiyan Hospital, Tehran, Iran. In total, 304 participants (65�85 years), were enrolled through the inclusion criteria from August to December 2019. The frailty index (FI) was assessed by the minimum data set-home care. Readmission was obtained through telephone interviews. The length of stay was gathered by the patient�s hospital records, and the EuroQol questionnaire was used for assessing the quality of life. Data were collected by a researcher nurse at the admission time, 30, 60, and 90 days after discharge. The logistic regression model and repeated measures ANOVA were employed to analyze the association between frailty and outcomes. Results: According to FI, 102 (33.55) participants were pre-frail, whereas 35 (11.51) were frail. In the fully-adjusted model for readmission, the pre-frail participants had a higher risk of readmission at the hospital in comparison with the nonfrail and frail groups (OR = 1.88, 95 CI = 1.90�3.26), and also for GP visits, frail patients showed nearly significant differences (OR = 2.45, 95 CI = 0.99�6.06) but there were no differences between frail and pre-frail patients in readmissions in the emergency ward. In a fully-adjusted prolonged stay model, pre-frail patients had a higher probability to stay longer in hospital (OR = 2.28, 95 CI: 1.24�4.18). The fully-adjusted model for QoL showed, frail patients were more prone to the declined levels of QoL in comparison with pre-frail patients (OR = 10.77, 95 CI: 3.97�29.18). Conclusions: The findings indicated that frailty worsened negative outcomes and declined QoL. Early diagnosis in hospital settincould be beneficial for designing optimal care plans for the frail and pre-frail patients. © T�BİTAK
Comparative survival of exopolysaccharide encapsulated Lactobacillus plantarum and Pediococcus pentosaceus in simulated gastrointenstinal conditions and storage time
No full textThe objective of the present study was to evaluate the effect of microbial exopolysaccharide (EPS) encapsulation of lactic acid bacteria on enhancing their viability during exposure to the simulated conditions of the gasterointestinal tract. Lactobacillus plantarum (NR104573.1) and Pediococcus pentosaceus (NR042058.1) isolated from wheat bran sourdough were encapsulated by spray-drying with various ratios of EPS, whey protein concentrate, carboxymethyl cellulose and pectin. The viability, kinetics and survival under stress conditions were compared between the samples after 120 min of incubation and over 28 days of storage. HPLC was used for compositional assessment in terms of monosaccharide constituents, revealing that glucose, arabinose and xylose were the major components of the EPS produced by L. plantarum and P. pentosaceus. ANOVA demonstrated a significantly reduced logarithmic cycle of bacterial population in the control samples and free cells compared to the encapsulated L. plantarum and P. pentosaceus after 2 h in simulated gastric fluid conditions and bile salt solution. Encapsulation yields in the presence of WPC, CMC and pectin with and without EPS were about 85 and 80 for L. plantarum, and it was 81 and 75 for P. pentosaceus, respectively. Also, the viability number of L. plantarum and P. pentosaceus free cells decreased over 28 days of storage from 12.41 to 7.28 and 12.11 to 6.96 log Cfu/mL, respectively. Finally, by assessing the kinetics of the bacteria with three mathematical models, the Ritger�Peppas kinetics model was found to be a suitable correlation model for the data. © 2020, Springer Science+Business Media, LLC, part of Springer Nature
Does the job category affect employments� organizational citizenship behavior in hospitals?
No full textBackground and Objective: Organizational citizenship behavior (OCB) is one of facilitating factors in improving the quality of service in healthcare section. This study aimed at investigating the possible relationship between the job category and employees� organizational citizenship behavior in some selected hospitals located in Northern Iran. Material and Methods: This applied research was a descriptive-analytical cross-sectional survey conducted in 2016 among therapeutic and non-therapeutic/administrative employees working in 5 selected hospitals located in Golestan province, Iran. 320 employees were selected randomly by using Cochran sampling formula. The Persian version of Podsakoff�s standard scale for measuring the organizational citizenship behavior was used for data collection. The gathered data were analyzed by using SPSS 18 and applying independent t-test and regression analysis. Results: The mean rate of nontherapeutic employees� organizational citizenship behavior (94.38±7.57) was higher than that of therapeutic ones (93.98±9.36). The component altruism with 20.78±2.75 among therapeutic staff and the component conscientiousness with 20.87±2.09 among non-therapeutic staff were in the highest rate. The mean differences of the components of the organizational citizenship behavior were not significant, The lowest rate belonged to the component civic virtue (14.28±2.03), but in altruism in which the difference was significantly positive (p=.039). Conclusion: Although the job category has a low effect on the organizational citizenship behavior, the managers of healthcare centers can improve their employees� organizational citizenship behavior by improving organizational culture, work motivation and job satisfaction among the staff. © 2021, Ibn Sina Trust. All rights reserved
Altered IFN-γ Levels after Treatment of Epileptic Patients with Omega-3 Fatty Acids
No full textEpilepsy is a frequent chronic disorder of the brain characterized by intermittent epileptic seizures caused by hypersynchronous discharge of neurons in the brain. Studies have reported the role of cytokines in the pathogenesis of epilepsy, and a number of investigations have shown decreased levels of omega-3 fatty acids in epileptic patients. We investigated differences in serum levels of two cytokines, transforming growth factor (TGF)-β and interferon (IFN)-γ, in 40 epileptic cases prior to and after treatment with omega-3 fatty acids. IFN-γ levels were significantly increased after the 16-week treatment period (P < 0.001). However, TGF-β levels remained unchanged (P = 0.14). Omega-3 fatty acid treatment may alter the immune response in epileptic patients. This should be considered in prescription of omega-3 fatty acid supplements in these patients. Future studies with larger sample sizes should verify the results of the current study. © 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature
Evaluation of diuretic and antioxidant properties in aqueous bark and fruit extracts of pine
No full textObjective: The present study has been carried out to evaluate the diuretic and antioxi-dant properties of pine herb in an animal model. Materials and Methods: 45 adult male rats were randomly divided into nine groups including: groups I (the negative control), groups II (positive control, furosemide 10 mg/kg), groups III to VIII (treatment groups received 100, 200, 400 mg/kg of the aqueous extracts of bark and fruit) and group IX received the combination of aqueous extract of bark (100 mg/kg) and the fruit (100 mg/kg). The urine output, glomerular filtration rate (GFR), electrolytes, urea, and creatinine levels were evaluated. Furthermore, the phenolic content and antioxidant activity of both extracts were also assessed using 2, 2-diphenyl-1-picrylhydrazyl (DPPH), ferric reducing antioxidant power (FRAP) and Folin�Ciocalteu methods. Results: The aqueous extracts of the pine bark and fruit increased the urinary output in a dose-dependent manner. The combination of the two extracts compared to the other extracts alone significantly increased the serum potassium level. This study also showed each extract increase creatinine clearance in a dose-dependent manner (p<0.01 and p<0.05). The increase of GFR in the combination group was not significant. The current data showed a significant increase in the total phenolic content in pine bark extract in compared with the fruit extract. Conclusion: The pine bark and fruit can be useful in the prevention and treatment of kidney stones due to the high diuretic properties and antioxidant activity. © 2021 Bentham Science Publishers