Prevalence of Chronic Diseases and Occupational Injuries and their Influence on the Health-Related Quality of Life Among Farmers Working in Small-Farm Enterprises

Objectives: This study aimed to determine the prevalence of chronic diseases and occupational accidents and injuries, and to examine their association with the quality of life among a sample of Iranian farmers.

Methods: A cross-sectional study was conducted among 736 male farmers. Data on the prevalence of chronic diseases and occupational accidents and injuries was collected using an author-developed questionnaire, and the SF-36 questionnaire was used to obtain information on quality of life.

Results: The prevalence of chronic diseases was 96.1%. Musculoskeletal diseases (MSDs), eye diseases and neurology diseases were the most prevalent diseases. Almost half of the farmers (42.7%) had experienced an occupational accident during the last 12 months and cuts and fractures accounted for the most frequent injuries. Sick leave was reported by 28.2% of the farmers and from those with history of accidents, 21.4% were hospitalized. A significant association was found between age and education level with quality of life. Most of the chronic diseases showed a significant and inverse association with quality of life, however, the strongest association was found for MSDs and mental disorders. Furthermore, the most important injury associated with quality of life was cuts and fractures.

Conclusions: Based on the results, MSDs, mental disorders, and cut and fractures were the main determinants of the farmers’ quality of life. Hence, a better quality of life among farmers is especially dependent on eliminating ergonomics risk factors leading to developing musculoskeletal disorders, improving psychosocial work climate, and promoting occupational and personal safety culture.     

Oestrogen promotes coronary angiogenesis even under normoxic conditions

Angiogenic therapy is one of the new treatments of ischaemic heart disease. Oestrogen has angiogenic properties under hypoxic condition, and if oestrogen also induces angiogenesis under normoxic condition, it could be used in combination with other angiogenic therapies in the treatment of ischaemic heart disease. In this study, we evaluated the angiogenic effect of high-dose oestrogen treatment in normoxic rat heart tissue. Fifty-two ovariectomized rats were randomized in oestrogen-treated and control groups. 17beta-oestradiol (1 mg/week) and normal saline (1 mg/week) were administered intramuscularly in the treatment and control groups for 2 months. After that, coronary capillary density and coronary vessel permeability were measured. The serum vascular endothelial growth factor (VEGF) level was also measured before and after the treatment. The results indicate that coronary capillary density (number of capillary per square millimetre) and coronary vessel permeability (fluorescence intensity) were significantly higher in the oestrogen-treated group than in the control group (628 +/- 26 per mm(2) versus 540 +/- 26 per mm(2); P < 0.05 and 207 +/- 10 versus 147 +/- 19 per gram tissue; P < 0.05). Oestrogen treatment increased serum VEGF level in the oestrogen-treated group compared to the control group (52 +/- 3 versus 33 +/- 6 pg/ml; P < 0.05), but interestingly VEGF was also increased in the control group after placebo treatment. It seems that high-dose oestrogen administration has angiogenic properties even in normoxic conditions. These angiogenic properties may result from oestrogen's direct effect on VEGF or other mechanisms, such as endothelial progenitor cell mobilization. Because of the broad effect of oestrogen on angiogenic growth factors and endothelial cells, more studies are required to clarify angiogenic properties of high-dose oestrogen.     

The Effect of Manual Acupressure (Point UB32) on Pain Associated with Intramuscular Injections of Magnesium Sulfate

The aim of this study was determining the effect of acupressure on the severity of pain associated with intramuscular injections of magnesium sulfate administered by the Z-track technique in patients with eclampsia and preeclampsia. Forty-eight patients participated in this single-group clinical trial, which was conducted in three stages. For each patient, three intramuscular injections were administered by the Z-track technique. The first injection was administered by the conventional method. The second injection at a sham control point and the third injection using acupressure (BL32) were administered. Pain severity was measured on a visual analogue scale. The mean pain intensity was 7.22 in the first, 4.75 in the second and 1.94 in the third injections (p < 0.001). The results of the study showed that acupressure at the BL32 point before intramuscular injection of magnesium sulfate significantly reduced the injection-related pain.     

The association between dietary glycemic index,glycemic load and diet quality indices in Iranian adults: results from Isfahan Healthy Heart Program

To assess the association between dietary glycemic index (GI), glycemic load (GL) and dietary quality indices in Iranian adults. This cross section was conducted among 1571 Iranian adults aged ≥19 years. GI, GL and diet quality indices were estimated by 24-h recall and DDS was calculated using a validated 48-item food frequency questionnaire. Participants who were in the top tertile of GI had lower healthy eating index (HEI) (57.2?±?7.8 versus 55.6?±?8.7; p?p?2. Individuals in the lowest tertile of GL had lower HEI, MAR and NARs for Zn, vitamin B₂, B₃, B₆, B₁₂, vitamin D. Both GI and GL were positively related to dietary diversity score (DED) (p?相似文献   

Durable complete response to pembrolizumab in microsatellite stable colorectal cancer

IntroductionImmunotherapy by checkpoint inhibitors, i.e., anti-programmed death-1(PD-1) or anti-programmed death-ligand 1 (PD-L1) antibodies, has gained more attention managing solid tumors. Pembrolizumab (an anti-PD-1 antibody) in metastatic colorectal cancer (CRC) was approved in 2017 by the US FDA.Reason for the reportPembrolizumab is not effective in microsatellite stable, mismatch-repair-proficient (MSS-pMMR) molecular phenotype, which comprises most CRC patients. In this report, we present the first case of metastatic CRC with a dramatic and durable response to pembrolizumab despite being of MSS-pMMR phenotype.Case summaryA 34-year-old woman, presented seven years ago with T3N2bM0 colon cancer and an appendix carcinoid tumor. The last relapse with bilateral pulmonary metastases was refractory to all treatments. Although it seemed unresponsive to immunotherapy because of MSS molecular phenotype, due to the high expression level of PD-L1 (85%), we started treatment with pembrolizumab 200 mg every three weeks and continued for the overall 19 courses. Surprisingly, a rapid and complete response was observed that last until now, i.e., 17 months after discontinuation of pembrolizumab.OutcomeDespite non-promising results in the current clinical trials, MSS-pMMR colorectal cancer patients'' deprivation from immunotherapy seems not to be reasonable. There are ongoing clinical trials on checkpoint inhibitors either alone or in combination with other drugs. However, immunostaining for PD-L1 should be considered as a possible response predictor.Graphical abstractImmunotherapy either by cell-based approaches or by checkpoint inhibitors may revolutionize cancer treatmentPembrolizumab has been approved by the FDA in 2017 for colorectal cancer.However, MSS-pMMR molecular phenotype which comprises the majority of CRC patients, has not shown a good response to checkpoint inhibitors.We present a MSS-pMMR case with complete and durable response to pembrolizumabWe suggest immunostaining for PD-L1 as a possible response predictor to checkpoint inhibitors     

Effect of stone composition,color,size,impaction and location on the efficacy of pneumatic ureterolithotripsy

Objective： Assessment of the relationship between stone location, composition, color, size and impaction with success rate of pneumatic ureterolithotripsy. Methods： This study was performed on 440 patients who were candidate for pneumatic ureterolithotripsy admitted in an academic urology department from February 2004 to June 2006. Exclusion criteria included active urinary tract infection and pregnancy. Information such as stone composition, color, impaction, size, location and surface were recorded. Success rate was defined as stone fragmentation to 〈 2 mm. We used chi-square test and student t-test for statistical analysis. Results： The success rate of pneumatic ureterolithotripsy was 83.0 %. Mean stone size was 9.86 ± 3. 79 mm. The stone free rates in upper, middle and lower ureter were 66.7%, 100% and 90.7% respectively （P 〈 0. 000 1 ）. Stone free rate was 100 % and 69.35% in 〈 5 mm and 〉 5 mm stones respectively （P 〈 0.000 1 ）. Impaction did not correlate significandy with stone free rate （P=0.17）. The success rate was 100 % in phosphate and cystine stones. There was a significant statistical difference between success rate and stone composition （ P = 0. 026）. The most common fragmented stone color was gold （95.5% ）. Stone color correlated significantly with stone free rate （P 〈 0.0001 ）. Conclusion： In this series ureterolithotripsy, stone free rate had a significant correlation with stone color, size, composition and location, but it was independent of stone impaction.     

Adenosine induces cell cycle arrest and apoptosis via cyclinD1/Cdk4 and Bcl-2/Bax pathways in human ovarian cancer cell line OVCAR-3

Adenosine is a regulatory molecule with widespread physiological effects in almost every cells and acts as a potent regulator of cell growth. Adenosine has been shown to inhibit cell growth and induce apoptosis in the several cancer cells via caspase activation and Bcl-2/Bax pathway. The present study was designed to understand the mechanism underlying adenosine-induced apoptosis in the OVCAR-3 human ovarian cancer cells. MTT viability, BrdU and cell counting assays were used to study the cell proliferation effect of adenosine in presence of adenosine deaminase inhibitor and the nucleoside transporter inhibitor. Cell cycle analysis, propidium iodide and annexin V staining, caspase-3 activity assay, cyclinD1, Cdk4, Bcl-2 and Bax protein expressions were assessed to detect apoptosis. Adenosine significantly inhibited cell proliferation in a concentration-dependent manner in OVCAR-3 cell line. Adenosine induced cell cycle arrest in G0/G1 phase via Cdk4/cyclinD1-mediated pathway. Adenosine induced apoptosis, which was determined by Annexin V-FITC staining and increased sub-G1 population. Moreover, down-regulation of Bcl-2 protein expression, up-regulation of Bax protein expression and activation of caspase-3 were observed in response to adenosine treatment. The results of this study suggest that extracellular adenosine induced G1 cell cycle arrest and apoptosis in ovarian cancer cells via cyclinD1/ Cdk4 and Bcl-2/Bax pathways and caspase-3 activation. These data might suggest that adenosine could be used as an agent for the treatment of ovarian cancer.     

Hemodynamic parameters and reproductive outcome after intracytoplasmic sperm injection and fresh embryo transfer in patients undergoing oocyte retrieval with general anesthesia using fentanyl,remifentanil or alfentanil – A randomized clinical trial

ObjectiveAnesthesia for assisted reproductive technology is very important to provide less stressful and painful environment for patients, with minimal side effects on oocytes. In the present study, we aimed to evaluate hemodynamic parameters, recovery time and intracytoplasmic sperm injection (ICSI) outcome among patients underwent anesthesia with fentanyl, remifentanil or alfentanil.Material and methodsThis randomized double-blinded clinical trial was conducted in patients undergoing anesthesia for transvaginal ultrasound guided oocyte retrieval (TUGOR). Patients were randomly allocated to alfentanil (A; 15 μg/kg), fentanyl (F; 1.5 μg/kg) or remifentanil (R; 1.5 μg/kg) groups.ResultsThree hundred forty patients were assessed for eligibility and randomized for transvaginal oocyte retrieval following general anesthesia and 105 were lost to follow up. No statistically significant differences were noted among groups regarding basic characteristics. Although, time to respond to verbal command was significantly different among groups (A: 1.99 ± 1.64, F: 2.56 ± 1.72, R: 1.78 ± 1.34, P = 0.014). There were no significant differences among groups with respect to the first and second postoperative pain intensity, patient satisfaction, pre-induction and post-induction systolic and diastolic blood pressure (BP). Terminal systolic (A: 101.61 ± 9.15, F: 105.29 ± 12.61, R: 102 ± 12.91, P = 0.01) and diastolic (A: 59.97 ± 9, F: 65.63 ± 9.13, R: 63.69 ± 11.01, P = 0.003) BP was significantly different among groups. The fertilization rate was significantly different among groups (A: 51.6%, F: 54.4%, R: 62.2%, P = 0.018). Implantation rate, biochemical and clinical pregnancy rate was similar among groups.ConclusionsThe results of present study demonstrated that all three opioids have the same efficiency, in regards to patient satisfaction and pregnancy outcome. However, Anesthesia with alfentanil compared with fentanyl and remifentanil, seems to be inferior for TUGOR due to higher effect on fertilization rate and less hemodynamic stability.Registration numberIRCT201410258677N4.