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Effect of acupressure in Pericardium 6 acupoint on nausea and vomiting after general surgery
Get PDFBackground:Nausea and vomiting are of the most common postoperative complications. Postoperative nausea and vomiting (PONV) can increase the patients' length of hospital stay, healthcare costs, and perioperative morbidity. Objective: The current study aimed to evaluate the effects of acupressure in preventing PONV in patients who have undergone general surgery with spinal anesthesia. Methods: This single-blind clinical trial was performed on 70 patients who had undergone general surgery and randomly assigned to an intervention and a control group. In the intervention group, the acupressure wristbands were fastened to one of the patients' wrist so that the pressing buttons were placed on the Pericardium 6 acupoint. In the control group, the wristbands without pressing buttons were loosely fastened on the desired point. The severity and episodes of nausea and vomiting were measured intraoperatively, 1, 3, and 7 h postoperatively. The data were analyzed via repeated measures analysis, t, and Chi-square tests. Results: Over time, the intervention significantly decreased the mean of nausea episodes (P< 0.001), nausea severity (P < 0.001), and vomiting episodes (P < 0.001) in the intervention group. In the comparison of the two groups, the repeated measures analysis showed that although after the intervention the values of all the three variables was lower in the intervention group than that of the control group, but these difference were only statistically significant in the episodes and the severity of nausea. Conclusion: The acupressure significantly reduced the severity and episode(s) of postoperative nausea, but it did not affect vomiting
Iranian nurses' perceptions of the conditions of the families with terminally ill patients: Family in limbo
Get PDFBackground:Understanding the conditions of terminally-ill patients' family members is the first step in reducing their emotional distress. Objectives: The aim of this study was to explore nurses' perceptions of the conditions of terminally ill patients' families. Methods: This qualitative content analysis study was conducted in 2016-2017. Participants were 24 nurses purposively recruited from 14 hospitals in Tehran, Iran. Data were collected through semi-structured interviews and analyzed through conventional content analysis. Results: Participants' perceptions were categorized into two main categories, namely, behavioral and emotional turmoil and perceived worries. The two subcategories of the first category were family turmoil after receiving bad news and family members' violent behaviors after receiving bad news. The second category included four subcategories, namely, feeling guilty, worries about patient's fate, worries about the aggravation of patient's conditions, and financial worries. The main theme of the study was family in limbo. Conclusion:Terminally ill patients' family members are in limbo due to behavioral and emotional turmoil and different worries. Nurses can use the findings of this study to help terminally ill patients' family members undergo a healthy grief
Caregiver burden and its associated factors in caregivers of children and adolescents with chronic conditions
Get PDFBackground: Few studies have been conducted on the burden of care in caregivers of children with chronic illnesses. This study investigated the burden of care and associated factors in first-degree caregivers of children and adolescents with chronic conditions. Methods: A cross-sectional study was conducted from June to September 2017 on 385 first-degree caregivers of children and adolescents with chronic disorders. Data were collected using the Zarit burden inventory which assesses the caregiver burden in physical, psychological, economic, and relational areas and has a total score from 0 to 88. Scores 61-88, 41-60, 20-40, and <20 indicate severe, moderate, mild, and no burden. Data were analyzed using descriptive statistics and Chi-Square, Fisher�s exact tests, t-test, analysis of variance, and multiple regression analysis. Results: The mean age of the caregivers and children were 38.20±8.04 and 8.90±4.90 years, respectively. Also, 33 (8.5), 135 (35.1), and 181 (47) of the caregivers suffered from severe, moderate, and mild burden, and only 9.4 perceived no burden. The mean caregiver burden scores were significantly different in terms of their education (P<0.001), job status (P=0.04), financial status (P<0.001), family size (P<0.001), numbers of children (P<0.001), numbers of children with chronic illnesses (P<0.01), type of supportive resources (P=0.004), and children�s education (P<0.01), type of disease (P<0.001), numbers of diseases (P<0.001), and interval of medical visits (P<0.001). Conclusion: Caregivers of children and adolescents with chronic disease are under pressure. Our study showed a number of factors influencing caregiver burden. Health care providers should plan familycentered care plans to decrease the burden of care in caregivers of children with chronic conditions. © 2019, Shriaz University of Medical Sciences. All rights reserved
Effects of melatonin supplementation on hormonal, inflammatory, genetic, and oxidative stress parameters in women with polycystic ovary syndrome
Get PDFPurpose: The aim of the current study was to evaluate the effect of melatonin administration on clinical, hormonal, inflammatory, and genetic parameters in women with polycystic ovarian syndrome (PCOS). Methods: The present randomized, double-blinded, placebo-controlled clinical trial was conducted among 56 patients with PCOS, aged 18�40 years old. Subjects were randomly allocated to take either 5 mg melatonin supplements (n = 28) or placebo (n = 28) twice a day for 12 weeks. Results: Melatonin administration significantly reduced hirsutism (β �0.47; 95 CI, �0.86, �0.09; P = 0.01), serum total testosterone (β �0.11 ng/mL; 95 CI, �0.21, �0.02; P = 0.01), high-sensitivity C-reactive protein (hs-CRP) (β �0.61 mg/L; 95 CI, �0.95, �0.26; P = 0.001), and plasma malondialdehyde (MDA) levels (β �0.25 μmol/L; 95 CI, �0.38, �0.11; P < 0.001), and significantly increased plasma total antioxidant capacity (TAC) levels (β 106.07 mmol/L; 95 CI, 62.87, 149.28; P < 0.001) and total glutathione (GSH) (β 81.05 μmol/L; 95 CI, 36.08, 126.03; P = 0.001) compared with the placebo. Moreover, melatonin supplementation downregulated gene expression of interleukin-1 (IL-1) (P = 0.03) and tumor necrosis factor alpha (TNF-α) (P = 0.01) compared with the placebo. Conclusions: Overall, melatonin administration for 12 weeks to women with PCOS significantly reduced hirsutism, total testosterone, hs-CRP, and MDA, while increasing TAC and GSH levels. In addition, melatonin administration reduced gene expression of IL-1 and TNF-α. Copyright © 2019 Jamilian, Foroozanfard, Mirhosseini, Kavossian, Aghadavod, Bahmani, Ostadmohammadi, Kia, Eftekhar, Ayati, Mahdavinia and Asemi
Pathogenic role of exosomes and microRNAs in HPV-mediated inflammation and cervical cancer: A review
No full textCervical cancer (CC) is the fourth most common cause of cancer death in women. The most important risk factor for the development of CC is cervical infection with human papilloma virus (HPV). Inflammation is a protective strategy that is triggered by the host against pathogens such as viral infections that acts rapidly to activate the innate immune response. Inflammation is beneficial if it is brief and well controlled; however, if the inflammation is excessive or it becomes of chronic duration, it can produce detrimental effects. HPV proteins are involved, both directly and indirectly, in the development of chronic inflammation, which is a causal factor in the development of CC. However, other factors may also have a potential role in stimulating chronic inflammation. MicroRNAs (miRNAs) (a class of noncoding RNAs) are strong regulators of gene expression. They have emerged as key players in several biological processes, including inflammatory pathways. Abnormal expression of miRNAs may be linked to the induction of inflammation that occurs in CC. Exosomes are a subset of extracellular vesicles shed by almost all types of cells, which can function as cargo transfer vehicles. Exosomes contain proteins and genetic material (including miRNAs) derived from their parent cells and can potentially affect recipient cells. Exosomes have recently been recognized to be involved in inflammatory processes and can also affect the immune response. In this review, we discuss the role of HPV proteins, miRNAs and exosomes in the inflammation associated with CC. © 2019 UIC
The protective effects of curcumin on cytotoxic and teratogenic activity of retinoic acid in mouse embryonic liver
No full textBackground: Retinoic acid (RA) is a synthetic vitamin derivative. It exerts toxic and teratogenic effects on the development of embryonic organs in dose- and time-dependent manners in mice. Curcumin is a compound obtained from rhizomes of turmeric (Curcuma longa) and has protective effects on teratogenic agents. The current study examined the effects of curcumin on embryos treated with RA. Methods: A total of 24 female NMRI mice (8-week-old pregnant mice) were investigated in the current study. All of them were treated for 10 days during days 15 to 50 of pregnancy. In the first group, the animals were fed with normal diets (control); in the second group, with 60 mg/kg all- trans RA; in the third group, with 10 mg/kg curcumin; and in the fourth group, with RA and curcumin in their diets. The animals were killed by cervical dislocation at the 18th day of pregnancy and embryos were separated from the uteruses. The embryo weight and crown rump (CR) length were measured, and the SPSS software was used to analyze data. Results: There was a significant increase in the lengths of CR and weights of embryos after using curcumin, but RA had no effect on the length of CR and weight of embryos at a dose of 60 mg/kg. Morphometric assay of liver tissue was performed, and data analysis indicated that there were significant differences between groups in terms of morphometric parameters of liver tissue. Therefore, RA increased the cell number and sinusoid diameter and decreased the cell areas in the embryonic liver tissue. However, curcumin decreased these side effects of RA on the embryonic liver tissue. Conclusion: The results indicated that curcumin could decrease the toxic and teratogenic effects of RA in mouse embryos. © 2019 Wiley Periodicals, Inc
Effect of Gd3+-, Pr3+- or Sm3+-substituted cobalt�zinc ferrite on photodegradation of methyl orange and cytotoxicity tests
No full textGd3+-, Pr3+- or Sm3+-doped Co-Zn (Co0.5Zn0.5Fe2O4) magnetic ferrites (i.e., Co0.5Zn0.5Gd0.1Fe1.9O4, Co0.5Zn0.5Pr0.1Fe1.9O4 and Co0.5Zn0.5Sm0.1Fe1.9O4) were prepared using a facile sol-gel approach, and the structure, surface morphology and chemical composition of the products were studied by means of scanning electron microscopy (SEM), energy dispersive X-ray analysis (EDX), X-ray diffraction (XRD), UV-visible diffuse reflectance spectroscopy (DRS), photoluminescence (PL) spectroscopy, Fourier transform infrared spectroscopy (FT-IR) and vibrating sample magnetometer (VSM) spectroscopy. XRD patterns show the Co-Zn product is composed of cubic spinel phases with few impurities or secondary phases, and the average crystallite sizes of the samples are determined to be approximately �51�80, �99�181, �68�103 and �83�133 nm. Also the coercivity and remnant and saturation magnetizations, evaluated by vibrating sample magnetometer (VSM), are found to increase linearly with the incorporation of Gd3+, Pr3+ and Sm3+ in the product formulation. The Co1�xZnxFe2�yRyO4 photocatalyst sample is found to display a red shift in its absorption, and exhibits outstanding photocatalytic effects in the degradation of MO under ultraviolet (UV) light. This is attributed to the reduction of the band gap of cobalt-zinc ferrite due to the presence of rare earth ions. Further in vitro evaluations of the cytotoxic effects of the synthesized nanoparticles were performed on a HeLa cell line. © 201
Characterization of carbapenem-resistant but cephalosporin-susceptible Pseudomonas aeruginosa
No full textIn this study, mechanisms of carbapenem resistance in carbapenem-resistant but cephalosporin-susceptible (Car-R/Ceph-S) Pseudomonas aeruginosa were investigated. A total of 243 P. aeruginosa isolates were studied. The disk diffusion and agar dilution methods were used for determination of antibiotic susceptibility patterns. AmpC and efflux pump overproductions were detected by phenotypic methods. The presence of carbapenemase-encoding genes was detected by polymerase chain reaction (PCR). The expression of OprD, MexAB-OprM, and MexXY-OprM efflux pumps was assessed by real-time PCR. According to disk diffusion method, altogether 116 P. aeruginosa isolates (47.7) were carbapenem-resistant and among them, 23 isolates (19.8) were cephalosporin-susceptible. Carbapenemase producer was not detected. Overexpression of AmpC was detected in one (4.3) isolate that was ceftazidime-susceptible but cefepime-resistant. Overexpression of MexAB-OprM and MexXY-OprM efflux pumps was detected in 12 (60.9) and 16 (68.8) of isolates, respectively. A total of 16 (68.8) isolates showed decreased expression of OprD. The Car-R/Ceph-S P. aeruginosa did not develop by carbapenemase production. The resistance to carbapenem was mediated in our clinical isolates by decreased expression of OprD and overexpression of MexAB-OprM and MexXY-OprM efflux systems or the combination of these mechanisms
Mesenchymal stem cell-derived exosomes: A new therapeutic approach to osteoarthritis?
Get PDFDegenerative disorders of joints, especially osteoarthritis (OA), result in persistent pain and disability and high costs to society. Nevertheless, the molecular mechanisms of OA have not yet been fully explained. OA is characterized by destruction of cartilage and loss of extracellular matrix (ECM). It is generally agreed that there is an association between pro-inflammatory cytokines and the development of OA. There is increased expression of matrix metalloproteinase (MMP) and "a disintegrin and metalloproteinase with thrombospondin motifs" (ADAMTS). Mesenchymal stem cells (MSCs) have been explored as a new treatment for OA during the last decade. It has been suggested that paracrine secretion of trophic factors, in which exosomes have a crucial role, contributes to the mechanism of MSC-based treatment of OA. The paracrine secretion of exosomes may play a role in the repair of joint tissue as well as MSC-based treatments for other disorders. Exosomes isolated from various stem cells may contribute to tissue regeneration in the heart, limbs, skin, and other tissues. Recent studies have indicated that exosomes (or similar particles) derived from MSCs may suppress OA development. Herein, for first time, we summarize the recent findings of studies on various exosomes derived from MSCs and their effectiveness in the treatment of OA. Moreover, we highlight the likely mechanisms of actions of exosomes in OA. © 2019 The Author(s)
Cultural competence in nursing: A concept analysis
Get PDFBackground: Cultural competence is one of the principal foundations of clinical nursing. It has not yet been clearly defined and analysed and there are different views regarding this issue. Objective: Analyzing the concept of cultural competence in nursing. Design: A concept analysis. Data Sources: The literature was searched using electronic databases including PubMed, ScienceDirect, Scopus, ProQuest, Google Scholar, CINAHL, Wiley, Ovid, Magiran, and SID with no date limitation. Any quantitative or qualitative studies published in English or Persian, which were focused on cultural competence in nursing were included in the study. Review methods: Walker and Avant's strategy for concept analysis was used. The attributes, antecedents, consequences, and uses of the concept were identified. Results: A total of 43 articles were included. The six defining attributes of cultural competence were cultural awareness, cultural knowledge, cultural sensitivity, cultural skill, cultural proficiency, and dynamicity. Antecedents included cultural diversity, cultural encounter and interaction, cultural desire, cultural humility, general humanistic competencies, educational preparation, and organizational support. The consequences of cultural competence were also identified: those related to care receivers, those related to care providers, and health-related consequences. Conclusion: A theoretical definition and a conceptual model of cultural competence were developed. The attributes, antecedents, and consequences of cultural competence identified in this study can be used in nursing education, research, and managerial and organizational planning. © 201