3790 research outputs found
Sort by
D-dimer as a diagnostic biomarker for pediatric/neonatal sepsis: A systematic review
No full textDiagnosis of sepsis is made based on clinical symptoms and laboratory findings, in which the clinical symptoms may be specific or nonspecific aim of D-dimer as a diagnostic biomarker for pediatric/neonatal sepsis. The researchers extracted all papers that had been published with the aim of examining pediatric and neonatal sepsis, and then they investigated them according to the inclusion and exclusion criteria, and finally included them. After the final conclusion and removal of the repeated papers, the results were reported using data frequency distribution table. In this study, in the initial search, 176 papers were found; after the initial and final screenings, the number reached 10 papers to be included in the SR stage. The total number of patients was 2075, on whom four studies had been done on one neonatal age group and six on children's age group. Furthermore, considering hospitalization in the ward, three studies had been done in NICU, 4 in PICU, and three studies in the pediatric ward. Moreover, the patients' mortality arranged from 0.9 to 52.7. In all examined studies, it was observed that the patients with more severe clinical status or those who had died had higher levels of DD compared to other patients. In patients with more serious clinical status or those that had died, DD level was reported higher compared to the other patients. It seems that DD level can be used as a factor for disease diagnosis and prognosis of the patients
Accuracy of Triage Systems in Disasters and Mass Casualty Incidents; a Systematic Review
No full textIntroduction: To prioritize patients to provide them with proper services and also manage the scarce resources in emergencies, the use of triage systems seems to be essential. The aim of this study was to evaluate the accuracy of the existing triage systems in disasters and mass casualty incidents. Methods: The present study is a systematic review of the accuracy of all triage systems worldwide. The results of this study were based on the articles published in English language journals. In this research, all papers published from the beginning of 2000 to the end of 2021 were sought through different databases. Finally, a total of 13 articles was ultimately selected from 89 articles. Results: 13 studies on the accuracy of triage systems were reviewed. The START, mSTART, SALT, Smart, Care Flight, ASAV, MPTT, Sieve and ESI triage systems, had an accuracy, sensitivity, and specificity of less than 90. Only the Smart triage system had an overall accuracy of more than 90. Conclusion: According to the findings of the current systematic review, the performance of the existing triage systems in terms of accuracy of prioritizing the injured people and other performance indexes is not desirable. Therefore, to improve the performance and increase the precision of triage systems, the world nations are recommended to change or revise the indexes used in triage models and also identify other influential factors affecting the accuracy of triage systems
Evaluating the Performance of PPE44, HSPX, ESAT-6 and CFP-10 Factors in Tuberculosis Subunit Vaccines
No full textMycobacterium tuberculosis (M. tuberculosis) is an intracellular pathogen causing long-term infection in humans that mainly attacks macrophages and can escape from the immune system with the various mechanisms. The only FDA-approved vaccine against M. tuberculosis (MTB) is Mycobacterium bovis bacillus Calmette-Guerin (BCG). The protection of this vaccine typically lasts 10-15 years. Due to the increasing number of people becoming ill with MTB each year worldwide, the need to develop a new effective treatment against the disease has been increased. During the past two decades, the research budget for TB vaccine has quadrupled to over half a billion dollars. Most of these research projects were based on amplifying and stimulating the response of T-cells and developing the subunit vaccines. Additionally, these studies have demonstrated that secretory and immunogenic proteins of MTB play a key role in the pathogenesis of the bacteria. Therefore, these proteins were used to develop the new subunit vaccines. In this review, based on the use of these proteins in the successful new subunit vaccines, the PPE44, HSPX, CFP-10 and ESAT-6 antigens were selected and the role of these antigens in designing and developing new subunit vaccines against TB and for the prevention of TB were investigated
Association between Influenza and COVID-19 Viruses and the Risk of Atherosclerosis: Meta-Analysis Study and Systematic Review
No full textThere is a lot of evidence to suggest that patients infected with the COVID-19 and influenza viruses are at risk of atherosclerosis. Additionally, there are heterogeneous studies on the risk of arthrosclerosis in patients infected with the influenza and COVID-19 viruses. We conducted a case-control and cross-sectional study and examined the association between the risk of atherosclerosis, and influenza virus (IV-A and IV-B) and COVID-19 infections in this study. We searched for keywords such as influenza virus, COVID-19 and atherosclerosis in English and Persian in well-known databases such as PubMed, SID, Magiran and Google Scholar. In this study, we analyzed the information using a meta-analysis, the random effect model, the I2 index and STAT (version 11.2). The results from the analysis of ten studies on influenza virus and nine studies on COVID-19 reviewed individually (totaling 6428 samples for influenza virus infections and 10,785 samples for COVID-19 infections) demonstrated a risk of arthrosclerosis in patients with influenza and COVID-19 infections, with an OR (odds ratio) = 0.45 ((95 CI): 0.25 to 0.64) and an OR (odds ratio) = 1.04 ((95 CI): 0.82 to 1.26), respectively. The present study provides new insights into the risk of atherosclerosis in patients infected with the COVID-19 and influenza viruses. Therefore, it seems necessary to consider different strategies for managing and eradicating viral infections among individuals
Changes in the expression of miR-103a and miR-21: a functional diagnosis of toxocariasis in rats
No full textIntroduction. Toxocariasis is a zoonotic parasitic disease caused by migrating nematode worms. Toxocara species larvae, within tissues. MicroRNAs (miRNAs) are small RNA molecules that regulate gene expression at a post-transcriptional level. Hypothesis/Gap Statement. miRNA-based diagnostic biomarkers for toxocariasis are emerging, but there is limited information about the role of many miRNAs and a more detailed diagnostic evaluation of miRNA expression patterns is needed to understand their immunobiological function. Aim. We investigated the expression levels of circulating miRNA 21 and miRNA 103a as potential biomarkers for the prediction and diagnosis of toxocariasis in Wistar rats infected with Toxocara canis. Methodology. Thirty Wistar rats were inoculated orally with 2500 T. canis embryonated eggs via gavage. Serum samples were collected from infected animals and were tested against T. canis antigens for 60 days post-infection. The plasma samples were isolated for quantitative real-time PCR (qPCR) assays and qPCR was used to assess transcription levels of miRNA 21 and miRNA 103a. Results. The prevalence of anti-Toxocara IgG was detected in 7/30 (23.3) infected rats. Molecular analysis of miRNAs 21 and 103a showed that expression levels of miRNAs in both groups of Toxocara-positive and negative samples were the same without significant association. The ratio of housekeeping gene expression (U6) to gene expression of miRNAs 21 and 103a indicated the rate of change (1/1.38 approximate to 0.75 and 1/0.751 approximate to 1.3, respectively). Conclusion. Our study revealed that miRNAs 21 and 103a might play fundamental roles as biomarkers and diagnostic tools for toxocariasis. However, the changes in expression of these miRNAs were not adequate to be used as biomarkers in diagnosis
Establishing a minimum data set for suicide and attempted suicide registry system in Iran
No full textBackground Suicidal behavior is a major cause of mortality and disability worldwide. Accurate and consistent collection of data on suicide, suicide ideation, and suicide attempts presents many challenges for public health practitioners, policymakers, and researchers. This study aimed to establish a minimum data set (MDS) for integrating data across suicide registries and other data sources. Methods The MDS proposed in this study was developed in two-stepwise stages. First, an extensive literature review was performed in order to identify the potential data items. Then, we conducted a two-round Delphi stage to reach a consensus among experts regarding essential data items and a supplementary one-round Delphi stage for validating the content of the final MDS by calculating the individual item content validity index (CVI) and content validity ratio (CVR) and using other statistical tests. Results After the literature review, 189 data items were extracted and sent to a panel of experts in the form of a questionnaire. In the Delphi stage and CVI calculation, 55 and 10 experts participated in kappa and CVR calculation, respectively. Finally, the MDS of the suicide registry was finalized with 84 data elements that were classified into four categories, including patient profile, socio-economic status, clinical and psychopathological status, and suicide circumstances. Conclusions The suicide MDS can become a standardized and consistent infrastructure for meaningful evaluations, reporting, and benchmarking of suicidal behaviors across regions and countries. We hope this MDS will facilitate epidemiological surveys and support policymakers by providing higher quality data capture to guide clinical practice and improve patient-centered outcomes
Efficacy and safety of fibrinogen administration in acute post-traumatic hypofibrinogenemia in isolated severe traumatic brain injury: A randomized clinical trial
No full textAim: This study was conducted to evaluate clinical outcomes after fibrinogen administration in hypofibrinogenemia following severe traumatic brain injury. Background: Post traumatic coagulopathy (PTC) is a common but devastating medical condition in patients with severe head injury. Hypofibrinogenemia is considered as an indicator for poor clinical outcomes in traumatic brain injury (TBI). Methods: In this randomized clinical trial (RCT), primarily 137 patients with severe traumatic brain injury (Glasgow coma scale score: GCS 200 mg/dL) could improve GOSE, GCS score progression within 3 days after primary head injury and hematoma expansion controllability
Design, development, and evaluation of a surveillance system for suicidal behaviors in Iran
No full textBackground Suicide is a serious cause of morbidity and mortality in Iran and worldwide. Although several organizations gather information on suicide and suicide attempts, there is substantial misperception regarding the description of the phenomenon. This study proposes the minimum data set (MDS) for suicidal behaviors surveillance. Methods A literature review was first conducted to achieve a thorough overview of suicide-related items and map the existing evidence supporting the development of the MDS. The data items included in the literature review were then analyzed using a two-round Delphi technique with content validation by an expert panel. The suicidal behaviors surveillance system was then established based on the confirmed MDS, and ultimately, its performance was assessed by involving the end-users. Results The panel of experts consisted of 50 experts who participated in the Delphi phase and validity content review. Of these, 46 were men, and their mean age and average work experience were (36.4, SD +/- 6.4) and (12.32, SD +/- 5.2) years, respectively. The final MDS platform of our study contained 108 items classified into eight main categories. A web-based system with a modular and layered architecture was developed based on the derived MDS. Conclusion The developed system provides a framework for recording suicidal behaviors' data. The integration of multiple suicide-related information systems at the regional and national levels makes it possible to assess the long-term outcomes and evolutions of suicide prevention interventions
Prevalence of ocular trauma in 6-12-year-old children living in Shahroud, Iran
No full textAim To determine the prevalence of ocular trauma in Iranian children aged 6-12 years. Methods This population-based cross-sectional study, comprised the first phase of the Shahroud Schoolchildren Eye Cohort Study on primary school children using cluster sampling in urban areas and census in rural areas. The students underwent the measurement of uncorrected and corrected visual acuity as well as non-cycloplegic, cycloplegic, and subjective refraction. The history of trauma, hospitalization, and surgery due to trauma was collected from parents using a questionnaire. Results The data of the trauma history was recorded for 5267 out of 5620 students. The mean age of the students was 9.7 +/- 1.7 years (range: 6-12 years), 53.7 of them were boys, and 79.3 were from urban areas. A positive history of ocular trauma was found in 285 participants, and the lifetime prevalence of ocular injury (95 CI) was 5.2 (4.6-5.9). Blunt trauma was the most common ocular injury with a prevalence of 66.2. There was a significant positive assocation between ocular trauma and living in rural areas (OR: 1.49, p: 0.012), older age (OR: 1.17, p < 0.001), and male sex (OR: 1.62, p: 0.002). Furthermore, 9.3 and 4.7 of the traumas required hospitalization and surgical intervention, respectively. Conclusion This study found a marked prevalence of ocular trauma compared to previous studies. Male sex, older age, and living in rural areas were associated with ocular trauma, which could be due to differences in lifestyle preference, outdoor exposure, and dangerous situations. Educational programs and safety instructions should be encouraged
Global status of antimicrobial resistance among environmental isolates of Vibrio cholerae O1/O139: a systematic review and meta-analysis
No full textBackground: Vibrio cholerae O1/O139 were the predominant circulating serogroups exhibiting multi-drug resistance (MDR) during the cholera outbreak which led to cholera treatment failures. Objective: This meta-analysis aimed to evaluate the weighted pooled resistance (WPR) rates in V. cholerae O1/O139 isolates obtained from environmental samples. Methods: We systematically searched the articles in PubMed, Scopus, and Embase (until January 2020). Subgroup analyses were then employed by publication year, geographic areas, and the quality of studies. Statistical analyses were conducted using STATA software (ver. 14.0). Results: A total of 20 studies investigating 648 environmental V. cholerae O1/O139 isolates were analysed. The majority of the studies were originated from Asia (n = 9). In addition, a large number of studies (n = 15 i.e. 71.4) included in the meta-analysis revealed the resistance to cotrimoxazole and ciprofloxacin. The WPR rates were as follows: cotrimoxazole 59, erythromycin 28, tetracycline 14, doxycycline 5, and ciprofloxacin 0. There was increased resistance to nalidixic acid, cotrimoxazole, furazolidone, and tetracycline while a decreased resistance to amoxicillin, ciprofloxacin, erythromycin, chloramphenicol, ampicillin, streptomycin, and ceftriaxone was observed during the years 2000-2020. A significant decrease in the doxycycline and ciprofloxacin-resistance rates in V. cholerae O1/O139 isolates was reported over the years 2011-2020 which represents a decrease in 2001-2010 (p < 0.05). Conclusions: Fluoroquinolones, gentamicin, ceftriaxone, doxycycline, kanamycin, and cefotaxime showed the highest effectiveness and the lowest resistance rate. However, the main interest is the rise of antimicrobial resistance in V. cholerae strains especially in low-income countries or endemic areas, and therefore, continuous surveillance, careful appropriate AST, and limitation on improper antibiotic usage are crucial