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Association between Serum HLA-G Levels in The First Trimester of Pregnancy and The Onset of Preeclampsia: A Systematic Review and Meta-analysis Study
No full textHuman leukocyte antigen G (HLA-G) levels are among the biomarkers suggested for pre-eclampsia (PE). This study is aimed at determining the possible relationship between low soluble HLA-G (sHLA-G) levels in maternal blood at the beginning of pregnancy and subsequent PE. We searched the international scientific databases of Web of Science, Embase, PubMed, Cochrane, and Scopus. We extracted the studies investigating the relationship between the serum levels of HLA-G in the first trimester of pregnancy and the onset of PE using the appropriate keywords. The collected data were analyzed using the random-effects meta-analysis model and STATA (version 14). A total of 5 studies met the eligibility criteria, and the total sample size was 668 subjects. The mean and SD age of case subjects was 31.41 & PLUSMN; 4.16 years, while it was 30.56 & PLUSMN; 3.5 for control subjects. According to the findings, there was an inverse relationship between HLA-G serum level in the first trimester of pregnancy and the subsequent onset of PE, standard mean difference (SMD)=-1.51 95% confidence interval (CI):-2.26,-0.75, I2=90.8%, P=0.000. Based on these results, low sHLA-G level in early pregnancy has a positive correlation with subsequent PE, and the significant role of sHLA-G in the early stages of placentation can be proven
Site-specific transgene integration in chimeric antigen receptor (CAR) T cell therapies
No full textChimeric antigen receptor (CAR) T cells and natural killer (NK) cells are genetically engineered immune cells that can detect target antigens on the surface of target cells and eliminate them following adoptive transfer. Recent progress in CAR-based therapies has led to outstanding clinical success in certain patients with leukemias and lymphomas and offered therapeutic benefits to those resistant to conventional therapies. The universal approach to stable CAR transgene delivery into the T/NK cells is the use of viral particles. Such approaches mediate semi-random transgene insertions spanning the entire genome with a high preference for integration into sites surrounding highly-expressed genes and active loci. Regardless of the variable CAR expression level based on the integration site of the CAR transgene, foreign integrated DNA fragments may affect the neighboring endogenous genes and chromatin structure and potentially change a transduced T/NK cell behavior and function or even favor cellular transformation. In contrast, site-specific integration of CAR constructs using recent genome-editing technologies could overcome the limitations and disadvantages of universal random gene integration. Herein, we explain random and site-specific integration of CAR transgenes in CAR-T/NK cell therapies. Also, we tend to summarize the methods for site-specific integration as well as the clinical outcomes of certain gene disruptions or enhancements due to CAR transgene integration. Also, the advantages and limitations of using site-specific integration methods are discussed in this review. Ultimately, we will introduce the genomic safe harbor (GSH) standards and suggest some appropriate safety prospects for CAR integration in CAR-T/NK cell therapies
Clinical, Immunological, and Genetic Findings in Iranian Patients with MHC-II Deficiency: Confirmation of c.162delG RFXANK Founder Mutation in the Iranian Population
No full textPurposeMajor histocompatibility complex class II (MHC-II) deficiency is a rare inborn error of immunity (IEI). Impaired antigen presentation to CD4 + T cells results in combined immunodeficiency (CID). Patients typically present with severe respiratory and gastrointestinal tract infections at early ages. Hematopoietic stem cell transplantation (HSCT) is the only curative therapy.MethodsWe describe the clinical, immunologic, and genetic features of eighteen unrelated Iranian patients with MHC-II deficiency.ResultsConsanguinity was present in all affected families. The median age at the initial presentation was 5.5 months (range 7 days to 18 years). The main symptoms included failure to thrive, persistent diarrhea, and pneumonia. Autoimmune and neurologic features were also documented in about one-third of the patients, respectively. Thirteen patients carried RFXANK gene mutations, two carried RFX5 gene mutations, and three carried a RFXAP gene mutation. Six patients shared the same RFXANK founder mutation (c.162delG); limited to the Iranian population and dated to approximately 1296 years ago. Four of the patients underwent HSCT; three of them are alive. On the other hand, nine of the fourteen patients who did not undergo HSCT had a poor prognosis and died.ConclusionMHC-II deficiency is not rare in Iran, with a high rate of consanguinity. It should be considered in the differential diagnosis of CID at any age. With the limited access to HSCT and its variable results in MHC-II deficiency, implementing genetic counseling and family planning for the affected families are mandatory. We are better determined to study the c.162delG RFXANK heterozygous mutation frequency in the Iranian population
Biochemical, Serological and Immunological Tests for Diagnosis of Coronavirus Disease 2019 (COVID-19) Patients: A Comprehensive Systematic Review and Meta-analysis
No full textBACKGROUND: Recent studies have suggested the role of primary laboratory tests in addition to clinical symptoms for patients suspected to have coronavirus disease 2019 (COVID-19), which play a significant role in the diagnosis of COVID-19. However, the results of these studies are contradictory. The present study was conducted to evaluate biochemical, serological, and immunological tests for the diagnosis of COVID-19 patients. METHODS: This study was presented in accordance with the PRISMA protocol. This protocol is registered with the code CRD42019145410 in PROSPERO. We conducted a comprehensive literature search in databases, including Web of Science, PubMed/Medline, CINAHL Scopus, Cochrane Library, EMBASE, Science Direct, and EBSCO to find citations from the beginning of January 2019 until the beginning of April 2020 without any restrictions. RESULTS: Finally, 51 studies, including 5,490 COVID-19 patients, were included in the present metaanalysis. The prevalence of different factors observed in laboratory findings was as follows: the prevalence of lymphopenia in patients with COVID-19 accounted for 51.6 (95 CI: 44.0-59.1), elevated C-reactive protein (CRP) was 63.6 (95 CI: 57.0-69.8), elevated erythrocyte sedimentation rate (ESR) was 62.5 (95 CI: 50.1-73.5), elevated tumor necrosis factor alpha (TNFalpha) was 28.7 (95 CI: 9.0-62.1), elevated serum amyloid-A level was 74.7 (95 CI: 50.0-89.7), elevated procalcitonin level was 72.6 (95 CI: 58.1-83.5), elevated interleukin-6 level was 59.9 (95 CI: 48.2-70.5), reduced CD3 level was 68.3 (95 CI: 50.1-82.2), reduced CD4 level was 62.0 (95 CI: 51.1- 71.6), elevated lactate dehydrogenase (LDH) level accounted for 53.1 (95 CI: 43.6-62.4), elevated brain natriuretic peptide (BNP) accounted for 48.9 (95 CI: 30.4-67.7), reduced albumin and reduced pre-albumin levels in patients with COVID-19 were estimated to be 54.7 (95 CI: 38.1-70.2) and 49.0 (95 CI: 26.6-71.8), and D-dimer level was 44.9 (95 CI: 31.0-59.6). CONCLUSION: The results show lymphopenia, elevated ESR level, elevated CRP level, elevated serum amyloid-A, elevated TNFalpha, elevated procalcitonin level, elevated interleukin-6 level, reduced CD3, reduced CD4, elevated BNP, elevated LDH, reduced albumin, reduced pre-albumin, and elevated Ddimer levels as the most common findings at the time of admission
Investigating the validity and reliability of the GLFS-25 questionnaire by factor analysis in the elderly hospitalized at the intensive and cardiac care units
No full textINTRODUCTION: Geriatric Locomotive Function Scale-25 (GLFS-25) is a 25-item tool most commonly used to diagnose locomotive syndrome in the elderly. The purpose of the present study was to investigate the validity and reliability of the GLFS-25 questionnaire using factor analysis. MATERIALS AND METHODS: This descriptive-analytical study was conducted on 186 elderly people. The GLFS-25 questionnaire contains 25 items, and each item is scored on a five-point Likert scale from 0 to 4. Data were analyzed by SPSS V.19 software. Descriptive (frequency, percentage, mean, and standard deviation) and inferential (Cronbach's alpha, correlation coefficient, Bartlett test, KMO index, scree plot, and factor analysis) statistics were used to present the findings. RESULTS: Factor analysis revealed two hidden factors in the four dimensions of the questionnaire (i.e., pain, daily activities, social relations, and mental health). The first factor, named mobility and its consequential concerns), with a variance percentage of 74.323, had an effect on questions No. 19, 11, 25, 16, 6, 24, 5, 4, and 3. The second factor, named the problems and risks associated with daily and social activities, with a variance percentage of 78.680, had an effect on questions No. 17, 22, 7, 18, 14, 20, 13, 9, 12, 8, 10, 21, 2, 15, 1, and 23. Cronbach's alpha coefficient among the questionnaire's dimensions was 78.4. CONCLUSION: The GLFS-25 questionnaire can be used as a valid and reliable tool to diagnose locomotive syndrome in the elderly
Experiences and challenges of nursing education in response to the COVID-19 pandemic: A qualitative study in Iran
No full textBACKGROUND: The preparedness of nurses in the COVID-19 pandemic, will be of great importance when it comes to the unknown future of the pandemic and other similar ones. Identifying their problems can lead to better planning, preparation, and management. This study aims to explore Iranian nurses' experience of their preparedness challenges to give an effective response to the pandemic. MATERIALS AND METHODS: A qualitative content analysis approach using semi-structured interviews was employed to explore nurses' preparedness experiences. 28 nurses were interviewed, after transcription of the interviews, a content analysis using constant comparison was performed for data analysis based on Graneheim and Lundman approach. RESULTS: The results of the study can be summarized in 6 main categories and 14 subcategories, such as the necessity of continuing educational workshops, the necessity of holding exercises in the same environment, the importance of familiarity with the pandemic, the importance of educating all those involved in providing services in the pandemic, the need for providing immersive education for the pandemic and the need for planning and practice concerning the pandemic. CONCLUSION: When nurses receive more support, they can have their best performance. up-to-date training can prepare nurses more effectively, which will, in turn, make prepared nurses available, maximize their efficiency, and minimize their adverse mental consequences. Nurse managers may support nurses and increase hospital resilience in such emergencies. Nurses indicated some issues including managers' support, workplace culture, education, physical space, access to PPE, and willingness to provide the best care. These findings can be helpful in the management of the pandemic and preparing nurses as a large group of healthcare workers. Necessary training, along with the provision of adequate resources, should be programmed to support this effective group of health providers
A comparison of the effect of Vitamin D and Vitamin E supplementations, alone, and in combination, on reducing the intensity and duration of dysmenorrhea in women: A randomized controlled trial
No full textObjective: The aim of this study is to compare the effect of Vitamin D and Vitamin E supplementations, alone, and in combination, on reducing the intensity and duration of dysmenorrhea in women who were referred to the Kowsar gynecological clinics of Shahid Motahari Hospital of Urmia University of Medical Sciences. Materials and Methods: A double‑blinded clinical trial was conducted on 112 women with dysmenorrhea who were randomly allocated into the four study groups. Finally, 100 women complete the study and received capsules containing a placebo (n = 25), 1000 IU of Vitamin D (n = 25), 400 mg of Vitamin E (n = 25), and 1000 IU of Vitamin D + 400 mg of Vitamin E (n = 25) every 24 h for 2 consecutive months at the beginning of the menstrual period. The pain intensity and duration among groups were compared before and after the intervention. Results: The mean menstrual pain duration in all three experimental groups (Vitamin E, Vitamin D, and the combination of them) was lower than the placebo group (all P < 0.05), and the mean pain intensity scores in all three experimental groups were significantly lower than the placebo group (all P < 0.05). The results (means) for all of the drugs administered at the end of the 2nd month were better than the 1st month (all P < 0.01). Conclusions: Vitamin E and Vitamin D, as well as their combination, are recommended as an effective and safe treatment for the management of the complications of dysmenorrhea. © 2023 Journal of Integrative Nursing | Published by Wolters Kluwer - Medknow
Protective effects of pretreatment or concomitant treatment with Hypericum extract on renal function and renal toxicity in cisplatin-induced nephrotoxicity
No full textIntroduction: Cisplatin is a strong anticancer medicine, but its use is limited due to the potential nephrotoxicity induction. Objectives: The present study seeks to determine the impact of Hypericum hydroalcoholic extract on cisplatin-induced nephrotoxicity. Materials and Methods: Thirty-two male rats were assigned to groups 1 to 4. Group 1, control (Cont); treated by saline (IP). Group 2, Cis; cisplatin intraperitoneal (IP), 7.5 mg/kg. Group 3, CisH; cisplatin + Hypericum (70 mg/kg, IP, for one week). Group 4, HCis; first treated with Hypericum for a week, followed by cisplatin. Renal tissue and blood samples were obtained a week after cisplatin injection for tissue assay and biochemical analysis. Kidney tissue damage score (KTDS), plasma creatinine (Cr), blood urea nitrogen (BUN), serum glutamate oxaloacetate transaminase (SGOT), serum glutamate pyruvate transaminase (SGPT), malondialdehyde (MDA), superoxide dismutase (SOD), and catalase (CAT) were measured. Results: Kidney weight showed significant differences between the treated groups and the Cont group (P < 0.001). Serum BUN, Cr, SGOT, and SGPT increased significantly in Cont (P < 0.01). BUN decreased in CisH and HCis groups compared to Cis group, although there was no significant difference. Serum Cr, SGOT, and SGPT decreased significantly in CisH and HCis groups compared to the Cis group (P < 0.05). MDA and KTDS increased in the Cis group and decreased significantly in the CisH and HCis groups compared to the Cis group (P < 0.05). Serum SOD and CAT decreased significantly in Cis compared to Cont (P < 0.05) and increased in CisH and HCis groups compared to Cis. There was no significant difference between the CisH and HCis groups in any of the measured parameters. Conclusion: This study reveals that pretreatment with Hypericum extract or its concomitant administration with cisplatin can moderate the side-effects of cisplatin, improve renal function and decrease lipid peroxidation, renal toxicity and the KTDS. © 2023 The Author(s); Published by Nickan Research Institute
Assessment of the Delirium Prevalence among Pediatric Patients Admitted to the Pediatric Intensive Care Unit in West of Iran
No full textBackground: Delirium is often not diagnosed or treated in pediatric intensive care unit (PICU). Delirium leads to a longer hospital stay period, which in turn can result in an increase in hospital treatment costs and an increase in the risk of nosocomial infections.Objectives: The present study aimed to determine the prevalence of delirium and its risk factors in PICU pediatric.Methods: This cross-sectional study was conducted in 2021-2022 in hospitals affiliated to Kermanshah University of Medical Sci-ences. The data collection instruments included the Richmond Agitation-Sedation Scale (RASS) and the Cornell Assessment of Pe-diatric Delirium (CAPD) questionnaire. Delirium was assessed by the researcher twice a day, in the morning and the evening. The assessment was carried out by a trained person, and the examination results were confirmed by an anesthesiologist who was a member of the research team. Data analysis was carried out using SPSS ver. 16.Results: According to our study results, the majority of the 89 examined patients were male (n = 52 cases, 59.8), aged 13-16 years (n = 37 cases, 42.5), and were admitted due to pneumonia (n = 24 cases, 27.6). The prevalence of delirium was higher in patients with pain and those requiring oxygen therapy (P < 0.05). Furthermore, the overall prevalence of delirium in PICU patients was 25.3 (n = 22 cases).Conclusions: Investigating the prevalence of delirium in all age groups - pediatric and adolescents, in particular - was found to be extremely important. It was also found that the prevalence of delirium in PICU patients was significant; therefore, it was recom-mended that necessary preventive and medical interventions should be made to deal with these patients
The prevalence of clarithromycin-resistant Helicobacter pylori isolates: a systematic review and meta-analysis
No full textBACKGROUND: Knowledge of global clarithromycin (CLA)-resistant rates of Helicobacter pylori (H. pylori) is crucial for decision of the most appropriate eradication therapies with good clinical outcomes. Therefore, this review and meta-analysis aimed to evaluate the global prevalence of the CLA resistance in H. pylori to provide some guidance for selecting the first-line antibiotics. METHOD: A comprehensive search was performed for relevant literature until April 2021 in PubMed, Embase, and Web of Science databases. Freeman-Tukey double arcsine transformation was performed to estimate the weighted pooled prevalence of resistance. RESULTS: The meta-analysis included 248 articles. The prevalence of CLA-resistant H. pylori was 27.53 (95 CI 25.41-29.69). The heterogeneity between reports was significant (I(2) = 97.80%, P 0.05). CONCLUSION: Overall CLA resistance rate was 27.53%, worldwide. The difference in CLA resistance rate among the included studies can be due to several reasons such as differences in antibiotic prescription rates in various geographic areas, use of different breakpoints or inaccurate criteria in performed studies, and the emergence of multidrug-resistant (MDR) strains