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Optimization and One-Step Purification of Recombinant V Antigen Production from Yersinia pestis
Full text linkThe purpose of this study was to develop an efficient and inexpensive method for the useful production of recombinant protein V antigen, an important virulence factor for Yersinia pestis. To this end, the synthetic gene encoding the V antigen was subcloned into the downstream of the intein (INT) and chitin-binding domain (CBD) from the pTXB1 vector using specific primers. In the following, the produced new plasmid, pTX-V, was transformed into E. coli ER2566 strain, and the expression accuracy was confirmed using electrophoresis and Western blotting. In addition, the effects of medium, inducer, and temperature on the enhancement of protein production were studied using the Taguchi method. Finally, the V antigen was purified by a chitin affinity column using INT and CBD tag. The expression was induced by 0.05 mM IPTG at 25 °C under optimal conditions including TB medium. It was observed that the expression of the V-INT�CBD fusion protein was successfully increased to more than 40 of the total protein. The purity of V antigen was as high as 90. This result indicates that V antigen can be produced at low cost and subjected to one-step purification using a self-cleaving INT tag. © 2020, Springer Science+Business Media, LLC, part of Springer Nature
Pulmonary Nocardiosis in Suspected Tuberculosis Patients: A Systematic Review and Meta-Analysis of Cross-Sectional Studies
Full text linkBackground: nocardiosis is an opportunistic infectious disease in immunocompromised patients. The most common form of nocardiosis infection in humans is pulmonary nocrdiosis caused by inhaling Nocardia species from the environment. Thus, this study aimed to evaluate the pulmonary nocardiosis in patients with suspected tuberculosis using systematic review and meta-analysis. Methods: We conducted a systematic search for cross-sectional studies focused on the pulmonary nocardiosis among patients with pulmonary tuberculosis based on the Preferred Reporting Items for Systematic reviews and Meta-analysis (PRISMA) published from January 2001 to October 2019. The search was conducted in MEDLINE/PubMed, Web of Science, Scopus, Cochrane Library, Google Scholar, Science Direct databases, and Iranian databases. Medical subject headings (MeSH) and text words were searched: "pulmonary nocardiosis", "nocardiosis", OR "nocardial infection", "pulmonary nocardial infections/agents", AND "pulmonary tuberculosis", OR "pulmonary TB", AND "Iran". Two of the reviewers enrolled independently articles published in English and Persian languages according to the inclusion and the exclusion criteria. Comprehensive Meta-Analysis software (Version 3.3.070) was used for meta-analysis. Results: Only 4 studies met the eligibility criteria. The pulmonary nocardiosis prevalence varied from 1.7 to 6.7. The combined prevalence of nocardiosis among patients with suspected pulmonary tuberculosis in Iran was 4.8 (95 CI: 3-7.3, Q=5.8, Z=12.7). No heterogeneity was observed between studies because I2 was 48.3. N. cyriacigeorgica and N. asteroides were reported as the prevalent isolates, respectively. Conclusions: This review showed in patients suspected TB when they were negative in all diagnosis laboratory tests, nocardiosis cases which be considered. © 2020 Susan MM., et al
Mobile phone usage in patients with type II diabetes and their intention to use it for self-management: A cross-sectional study in Iran
Full text linkBackground: Mobile health has potential for promotion of self-management in patients with chronic diseases. This study was conducted to investigate smartphone usage in patients with type II diabetes and their intention to use it for self-management. Methods: This cross-sectional study was conducted in 2018 with 176 patients with type II diabetes visiting a specialized diabetes clinic or one of two endocrinology and metabolism specialists in north of Iran. Data were collected using a validated questionnaire containing items on demographic characteristics, disease information, use of mobile phones, smartphones and the internet, and intention to use mobile phones for diabetes self-management. Results: The majority of the participants had mobile phones (94.9), smartphones (61.1), and daily access to the internet (81.3), and used phones two hours per day on average (80.1). They mostly used mobile phones to contact friends (89.2) and search for information (50.6), and their greatest intention for using smartphones and the internet for self-management was related to dietary planning (96), checking blood glucose (90.9), and contacting specialists (87.5). Younger participants were more interested in using smartphone applications (apps) (P < 0.001). About half of the participants argued that using apps can be interesting (54) and useful (50) for diabetes management, and intended to use apps much more in future (48.3). Conclusions: The majority of patients with type II diabetes are inclined to use mobile phone and the Internet, especially to plan their diet, check blood glucose, and contact their doctors. The present study provides valuable information for designing and implementing interventions based on mHealth to promote self-management in type II diabetes. © 2020 The Author(s)
Optimizing cholecystectomy time in moderate acute biliary pancreatitis: A randomized clinical trial study
Full text linkBackground: In mild to moderate gallstone pancreatitis, cholecystectomy is the most appropriate treatment for prevention of further biliary attacks. However, the timing of cholecystectomy is not precisely determined. The present study was conducted to compare outcomes of very early (within 48 h) versus delayed (more than 1 week) laparoscopic cholecystectomy in patients with acute biliary pancreatitis (ABP). Methods: This randomized clinical trial study was conducted in Shahid Beheshti Hospital of Kashan University of Medical Sciences from September 2016 to Mar 2019. Two hundred and eight cases with mild to moderate ABP were randomly assigned to 2 groups, with 104 patients in group 1 (operation within 48 h) and 104 in group 2 (operation after one week). Age, sex, biochemical parameters, clinical manifestation at the time of admission, operation time, recurrent biliary problems, relapse, peri-operative complications, conversion rate, and hospital length of stay in the two groups were recorded and compared. In addition, Ranson's score and Revised Atlanta criteria, the American Society of Anaesthesiologists Physical Status ASA-PS, Charlson Co-Morbidity Index (CCI), complexity of surgery and Clavien-Dindo score were also determined. Results: There were no differences in demographics, peri-operative complications 4 (4) vs. 4 (4), P = 1), conversion rate (10.6 vs. 11.5; P = 0.825) and procedure time (83 vs. 81 minutes, P = 0.110) between the two groups. There were no deaths in either group; however, the length of hospital stay was shorter in the early group compared to the delayed one, (3.66 ± 1.12 vs. 10.35 ± 1.76, P < 0.001). Conclusion: Cholecystectomy within 48 h decreases significantly the length of hospital stay, without any difference in conversion rate, procedure time, or complication rate. © 2020 The Author(s) Biological sciences; Health sciences; Surgery; Internal medicine; Acute biliary pancreatitis; Laparoscopic cholecystectomy; Mild to moderate acute biliary pancreatitis. © 2020 The Author(s
Exosomal miRNAs: Novel players in viral infection
Full text linkExosomes are secreted nanovesicles that are able to transfer their cargo (such as miRNAs) between cells. To determine to what extent exosomes and exosomal miRNAs are involved in the pathogenesis, progression and diagnosis of viral infections. The scientific literature (PubMed and Google Scholar) was searched from 1970 to 2019. The complex biogenesis of exosomes and miRNAs was reviewed. Exosomes contain both viral and host miRNAs that can be used as diagnostic biomarkers for viral diseases. Viral proteins can alter miRNAs, and conversely miRNAs can alter the host response to viral infections in a positive or negative manner. It is expected that exosomal miRNAs will be increasingly used for diagnosis, monitoring and even treatment of viral infections. © 2020 Future Medicine Ltd
The effects of cast-related training for nurses on the quality of cast care: A quasi-experimental study
No full textIntroduction: Quality cast application and care is among the nursing skills which require competence, knowledge, and expertise. This study aimed to assess the effects of cast-related training for nurses on the quality of pre-, intra- and post-casting care. Methods: This quasi-experimental study was conducted in 2018 in two phases: before and after a cast-related training for nurses involved in cast application and care. In the first phase, 94 patients with a cast were assessed for pre- intra- and post-casting care quality. In the second phase, after the training program, the same number of new patients were assessed. Study data were collected using a 57-item checklist with items on; patient preparation, cast application, and post-casting care including patient education. Descriptive statistics, Fisher's exact, and independent-samples t-tests were used to analyze the data. Results: The mean pre-casting care score significantly increased from 1.39 ± 0.16 at baseline to 1.69 ± 0.32 after the intervention (P = 0.001). The mean intra-casting care score increased from 1.42 ± 0.31 at baseline to 1.52 ± 0.17 after the intervention (P = 0.014). However, the study intervention did not improve the mean post-casting care score. Conclusion: This training program improved the quality of pre- and intra-casting care, but did not improve the post-casting care and care measures related to patient education. Therefore, regular in-service training programs for nurses are recommended to improve their knowledge, skills, and performance in cast- pplication and care. © 2020 Elsevier Lt
The effect of prostate cancer radiotherapy on testosterone level: A systematic review and meta-analysis
No full textIntroduction: In the current study, a systematic search and meta-analysis were performed to evaluate the effect of prostate cancer radiotherapy on testosterone levels of patients. Methods: To illuminate the effect of radiotherapy on the testosterone level of prostate cancer patients, a systematic search was conducted in accordance with the PRISMA guideline in electronic databases of Scopus, Embase, PubMed, Web of Science, and clinical trials up to December 2018 using relevant keywords. Based on a certain set of inclusion and exclusion criteria, 12 eligible studies that had data on the testosterone level following prostate cancer radiotherapy were included in the meta-analysis. Results: According to the various techniques of prostate cancer radiotherapy, the dose values scattered to the testicular tissues ranged from 0.31 to 10 Gy. Combining the findings from 12 studies, it was found that prostate cancer radiotherapy leads to a significant reduction in the testosterone level (Weighted Mean Difference WMD:-51.38 ng/dL, 95% CI:-75.86,-26.90, I2=0.0%, P<0.05). Furthermore, subgroup analysis by the patient number showed a significant reduction in the testosterone level at patient number < 50 (WMD:-80.32 ng/dL, 95% CI:-125.10,-35.55, I2= 0.0%) and 50 < patient number < 100 (WMD:-46.99 ng/dL, 95% CI:-87.15,-6.82, I2= 0.0%). Subgroup analysis based on treatment technique type revealed a significant reduction in testosterone level after conventional radiotherapy (WMD:-56.67, 95% CI:-100.45,-12.88, I2= 34.3%) and IMRT/SBRT technique (WMD:-57.42, 95% CI:-99.39,-15.46, I2= 0.0%) in comparison with the proton therapy (WMD: 0.00, 95% CI:-80.24, 80.24). Conclusion: The findings showed a significant decrease in the testosterone level of prostate cancer patients after radiotherapy compared with pre-treatment levels. © 2020 Bentham Science Publishers
The global, regional, and national burden of inflammatory bowel disease in 195 countries and territories, 1990�2017: a systematic analysis for the Global Burden of Disease Study 2017
Full text linkBackground: The burden of inflammatory bowel disease (IBD) is rising globally, with substantial variation in levels and trends of disease in different countries and regions. Understanding these geographical differences is crucial for formulating effective strategies for preventing and treating IBD. We report the prevalence, mortality, and overall burden of IBD in 195 countries and territories between 1990 and 2017, based on data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017. Methods: We modelled mortality due to IBD using a standard Cause of Death Ensemble model including data mainly from vital registrations. To estimate the non-fatal burden, we used data presented in primary studies, hospital discharges, and claims data, and used DisMod-MR 2.1, a Bayesian meta-regression tool, to ensure consistency between measures. Mortality, prevalence, years of life lost (YLLs) due to premature death, years lived with disability (YLDs), and disability-adjusted life-years (DALYs) were estimated. All of the estimates were reported as numbers and rates per 100 000 population, with 95 uncertainty intervals (UI). Findings: In 2017, there were 6·8 million (95 UI 6·4�7·3) cases of IBD globally. The age-standardised prevalence rate increased from 79·5 (75·9�83·5) per 100 000 population in 1990 to 84·3 (79·2�89·9) per 100 000 population in 2017. The age-standardised death rate decreased from 0·61 (0·55�0·69) per 100 000 population in 1990 to 0·51 (0·42�0·54) per 100 000 population in 2017. At the GBD regional level, the highest age-standardised prevalence rate in 2017 occurred in high-income North America (422·0 398·7�446·1 per 100 000) and the lowest age-standardised prevalence rates were observed in the Caribbean (6·7 6·3�7·2 per 100 000 population). High Socio-demographic Index (SDI) locations had the highest age-standardised prevalence rate, while low SDI regions had the lowest age-standardised prevalence rate. At the national level, the USA had the highest age-standardised prevalence rate (464·5 438·6�490·9 per 100 000 population), followed by the UK (449·6 420·6�481·6 per 100 000). Vanuatu had the highest age-standardised death rate in 2017 (1·8 0·8�3·2 per 100 000 population) and Singapore had the lowest (0·08 0·06�0·14 per 100 000 population). The total YLDs attributed to IBD almost doubled over the study period, from 0·56 million (0·39�0·77) in 1990 to 1·02 million (0·71�1·38) in 2017. The age-standardised rate of DALYs decreased from 26·5 (21·0�33·0) per 100 000 population in 1990 to 23·2 (19·1�27·8) per 100 000 population in 2017. Interpretation: The prevalence of IBD increased substantially in many regions from 1990 to 2017, which might pose a substantial social and economic burden on governments and health systems in the coming years. Our findings can be useful for policy makers developing strategies to tackle IBD, including the education of specialised personnel to address the burden of this complex disease. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens
Comparing the effects of interactive and noninteractive education using short message service on treatment adherence and blood pressure among patients with hypertension
Full text linkBackground: Poor treatment adherence among patients with chronic conditions is a major global health-care problem. Objectives: The aim of this study was to compare the effects of interactive and noninteractive education using short message service (SMS) on treatment adherence and blood pressure among patients with hypertension (HTN). Methods: This single-blind pretest-posttest randomized controlled clinical trial was conducted on 63 adult patients with HTN who were consecutively recruited from a military hospital in Tehran, Iran, and were randomly allocated to an interactive SMS (ISMS), a non-ISMS (NISMS), and a control group. Initially, all patients in all groups were individually trained about HTN and adherence to its treatments in a 45-min session. Then, four messages were weekly sent for four consecutive months to those in the ISMS and the NISMS groups. The Treatment Adherence Questionnaire for Patients with Hypertension was used to assess treatment adherence both before and after the study intervention. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were also measured before and every 1 month during the study. Data were analyzed using the paired sample t, the Chi-square, and the Fisher's exact tests as well as the one-way and the repeated-measures analysis of variance. Results: At baseline, the mean score of treatment adherence was 81.43 ± 9.15 in the ISMS group, 81.14 ± 7.21 in the NISMS group, and 83.38 ± 14.43 in the control group. After the intervention, the mean score of treatment adherence in the ISMS group significantly increased to 89.67±4.47 (P = 0.003), while it insignificantly changed to 83.24 ± 7.18 in the NISMS group (P = 0.15) and to 87.86±6.62 in the control group (P = 0.16). The among-group difference respecting the posttest mean score of treatment adherence was statistically significant (P = 0.004). Although the means of SBP and DBP significantly decreased in both the intervention groups (P 0.05), the among-group differences respecting the variations of SBP and DBP across the four measurement time points were not statistically significant (P > 0.05). Conclusion: ISMS-based education is effective in significantly promoting treatment adherence, while neither interactive nor NISMS-based educations are effective in significantly reducing blood pressure among patients with HTN
