Associação entre o polimorfismo rs7700944 no gene TIM-4 e artrite reumatoide em Zahedan,sudeste do Irã

IntroductionRecently, an association between rheumatoid arthritis (RA) and the rs7700944 G>A variant in the T-cell immunoglobulin and mucin domains 4 (TIM-4) has been reported.ObjectiveThe present study aimed at investigating the impact of that polymorphism on susceptibility to RA in a sample of the Iranian population.Patients and methodsThis case-control study was conducted on 120 patients with RA and 120 healthy subjects. The rs7700944 polymorphism in the TIM-4 gene was determined using tetra amplification refractory mutation system-polymerase chain reaction (T-ARMSPCR) assay.ResultsNo significant difference was observed regarding the rs7700944 polymorphism of the TIM-4 gene between patients with RA and normal individuals. In females, no significant association was found between the groups concerning the rs7700944 polymorphism of the TIM-4 gene. In males, the GA+AA genotype increased the risk of RA in comparison with the GG genotype (OR = 5.15, 95% CI = 1.30-20.48, P = 0.020). Furthermore the results showed that the rs7700944 A allele increased the risk of RA (OR = 4.39, 95% CI = 1.43-13.54, P = 0.009).ConclusionOur results do not support an association between the rs7700944 polymorphism of the TIM-4 gene and RA. An interaction between this polymorphism and sex suggests a sex-specific association between this single nucleotide polymorphism and RA, which remains to be fully elucidated.     

Typodont versus live patient: predicting dental students' clinical performance

In this study, the authors evaluated the accuracy and precision of non-clinical testing for dental students' crown preparation proficiency on a manikin-mounted typodont as a predictor of performance on patients. Eighty-six seniors at Baylor College of Dentistry were evaluated by three calibrated senior faculty members from the general dentistry department. Four areas of interest were evaluated: occlusal reduction; axial reduction; margins, design, and finish line; and operative environment. Standardized grading scales were utilized to evaluate these preparation components. The kappa agreement statistic was used to assess agreement for the areas, which were then compiled to get an overall performance score. A Bland-Altman plot was generated and analyzed for agreement on overall performance between typodont and patient. Results of the analyses showed weak agreement between the two measurements for all four areas of interest with large variation in the differences. When the pairs of overall performance scores were compared, the Bland-Altman plot indicated that the typodont composite score was often larger than the patient composite score, especially for poorer performing students. The authors conclude that students' clinical performance on typodonts is a poor predictor of their clinical performance on patients since the students performed much worse on the clinical crown examination than on the typodont examination.     

Isolated superior mesenteric venous thrombophlebitis with acute appendicitis

INTRODUCTIONIsolated superior mesentericveinous thrmbophlebitis is a rarely recognised condition associated with a high morbidity. It usually develops secondary to infection in the drainage area of the portal venous system, like appendix.PRESENTATION OF CASEWe report a case of neglected perforated acute appendicitis complicated by superior mesenteric venous pyelephlebitis patiant represented with a vague pain to right of umlicus, which is atypical this why cat scan was done and showed obstructed superiormesentric vein, portal vein was free with acute appendicitis. Appendicectomy and treatment with broad-spectrum antibiotics, anticoagulation, and platelets led to a full recovery. Follow-up imaging after one month revealed complete canalization of superior mesentric vein.DISCUSSIONAbdominal pain if atypical like our case report need imaging diagnosis. Modern diagnostic imaging techniques help the early diagnosis of acute phase pylephlebitis. CT can detect primary source of infection, extent of pylephlebitis, CT scan is the most reliable initially. Ultrasound scan with color flow Doppler is also a sensitive test for confirming partial patency of the portal vein and portal vein thrombosis accidentally discovered complete obliteration of superior mesenteric vein with thrombosis which remained not propagated by serial Doppler ultrasound of liver.Appropriate treatment should be initiated as soon as possible. To avoid extension to portal vein. The principal treatment for pylephlebitis is to remove the source of infection as appendicectomy.Anticoagulants must be used. Regarding the treatment of portal thrombosis, post operative use of heparin has been advocated.CONCLUSIONCat scan play an important role in case of atypical abdominal pain.     

A comparative study between amiodarone and magnesium sulfate as antiarrhythmic agents for prophylaxis against atrial fibrillation following lobectomy

Purpose

Atrial fibrillations are common after thoracic surgery. Amiodarone and magnesium sulfate have been used for the management of atrial fibrillation following cardiac and non-cardiac surgery. However, to our knowledge, comparisons of both drugs with each other and with a control group in relation to the prevention of AF following lung surgery have not been performed. Our primary aim in this study was to prospectively evaluate the prophylactic effects of magnesium sulfate and amiodarone used separately and compare them with a control group analyzed retrospectively during and following lobectomy surgeries.

Patients and methods

The prophylactic value of amiodarone (group A; 219 patients) administered as an intravenous infusion (15 mg/kg for 48 h postoperatively) after a loading dose (5 mg/kg) was compared with magnesium sulfate (group M; 219 patients) administered intravenously as a loading dose (80 mg/kg magnesium sulfate over 30 min preoperatively) and then as an intravenous infusion (8 mg/kg/h for 48 h) in 438 patients undergoing lobectomy. These two groups were compared with a control group of 219 patients who were analyzed retrospectively.

Results

The results showed significantly lower incidences of AF in groups A and M when compared with group C (P < 0.05). There was no significant difference between the amiodarone and magnesium sulfate groups. However, the incidence of postoperative AF was lower in the amiodarone group, where only 21 (10 %) patients developed AF in comparison to 27 (12.5 %) patients in the magnesium sulfate group. Group C showed a higher incidence, 44 (20.5 %) patients, when compared with both groups. In addition, there were significant differences between the three groups concerning intensive care unit (ICU) and total hospital stays (P < 0.05).

Conclusion

Our study showed that during the intra- and postoperative periods, both amiodarone and magnesium sulfate are effective at preventing the incidence of atrial fibrillation following lung resection surgery in comparison to the control group.     

The effect of demographic and lifestyle changes on the burden of breast cancer in Iranian women: A projection to 2030

Iran is rapidly becoming an “ageing society” with a related increase in cancer incidence including breast cancer. This paper evaluates the trend in breast cancer incidence from the past to the present, in order to predict the future burden in Iran and to quantify the effect of changes in known risk factors on incidence over time. Currently, breast cancer incidence in Iran is low with approximately 5000 new cases annually. Under conservative assumptions, the number of new cases of breast cancer in 2030 will be more than 15000. In addition to demographic factors, changes in the prevalence of established risk factors such as reproductive factors and obesity are likely to result in changes in breast cancer patients over time. Extrapolating the increasing prevalence of obesity to the future, we expect that this specific factor will strongly contribute to the increased breast cancer incidence in the future unless preventive measures counteract this effect.     

Evaluation of clinical outcomes of cementless total hip arthroplasty in patients under 30 years of age

Background

Historically, performing a successful hip joint replacement in patients aged fewer than 30 years has been an orthopedic challenge. The newer generation of prostheses and surgical techniques has the potential to increase the longevity of implants. The purpose of this study was to evaluate the outcomes of cementless hip arthroplasty in patients aged fewer than 30 years.

Materials and methods

In this cross-sectional study, 41 patients (46 hips) were studied with a mean age of 24, 4 (from 17 to 30 years) of whom underwent cementless metal–polyethylene hip arthroplasty from 2004 to 2007. The Harris hip score (HHS) was used to assess the functional consequences. Patients were followed up in terms of early complications (thrombophlebitis of the lower limbs, dislocation, hematoma and infection) and late complications (aseptic loosening, dislocation and reoperation) at weeks 3 and 6, at 3 and 6 months, 1 year after surgery and annually thereafter.

Results

Patients were followed for an average of 5 years and 2 months (from 51 to 82 months). One early complication (symptomatic thrombophlebitis) and one late dislocation (2.2 %) were observed. There were no cases of aseptic loosening or osteolysis at the end of follow-up. The preoperative HHS was 59.6 (from 41 to 76), which rose to 82 and 83.5 after the 1-year and final follow-up, respectively, which was a significant increase.

Conclusions

Hip arthroplasty using a new generation of cementless proximal porous prosthesis with resistant polyethylene to cover the joint surfaces in patients aged fewer than 30 years is satisfactory and is accompanied by low complications.     

Measuring Tissue Perfusion During Pressure Relief Maneuvers: Insights Into Preventing Pressure Ulcers

Abstract

Background/Objective: To study the effect on tissue perfusion of relieving interface pressure using standard wheelchair pushups compared with a mechanical automated dynamic pressure relief system.

Design: Repeated measures in 2 protocols on 3 groups of subjects.

Participants: Twenty individuals with motor-complete paraplegia below T4, 20 with motor-complete tetraplegia, and 20 able-bodied subjects.

Methods: Two 1-hour sitting protocols: dynamic protocol, sitting configuration alternated every 10 minutes between a normal sitting configuration and an off-loading configuration; wheelchair pushup protocol, normal sitting configuration with standard wheelchair pushup once every 20 minutes.

Main Outcome Measures: Transcutaneous partial pressures of oxygen and carbon dioxide measured from buttock overlying the ischial tuberosity and interface pressure measured at the seat back and buttocks. Perfusion deterioration and recovery times were calculated during changes in interface pressures.

Results: In the off-loading configuration, concentrated interface pressure during the normal sitting configuration was significantly diminished, and tissue perfusion was significantly improved. Wheelchair pushups showed complete relief of interface pressure but incomplete recovery of tissue perfusion.

Conclusions: Interface pressure analysis does not provide complete information about the effectiveness of pressure relief maneuvers. Measures of tissue perfusion may help establish more effective strategies. Relief achieved by standard wheelchair pushups may not be sufficient to recover tissue perfusion compromised during sitting; alternate maneuvers may be necessary. The dynamic seating system provided effective pressure relief with sustained reduction in interface pressure adequate for complete recovery of tissue perfusion. Differences in perfusion recovery times between subjects with spinal cord injury (SCI) and controls raise questions about the importance of changes in vascular responses to pressure after SCI.     

Disruption of ATP-binding cassette B8 in mice leads to cardiomyopathy through a decrease in mitochondrial iron export

Mitochondrial iron levels are tightly regulated, as iron is essential for the synthesis of Fe/S clusters and heme in the mitochondria, but high levels can cause oxidative stress. The ATP-binding cassette (ABC) transporter ABCB8 is a mitochondrial inner membrane protein with an unknown function. Here, we show that ABCB8 is involved in mitochondrial iron export and is essential for baseline cardiac function. Induced genetic deletion of ABCB8 in mouse hearts resulted in mitochondrial iron accumulation and cardiomyopathy, as assessed by echocardiography and invasive hemodynamics. Mice with ABCB8 deletion in the heart also displayed mitochondrial damage, and higher levels of reactive oxygen species and cell death. Down-regulation of ABCB8 in vitro resulted in decreased iron export from isolated mitochondria, whereas its overexpression had the opposite effect. Furthermore, ABCB8 is needed for the maturation of the cytosolic Fe/S proteins, as its deletion in vitro and in vivo led to decreased activity of cytosolic, but not mitochondrial, iron-sulfur-containing enzymes. These results indicate that ABCB8 is essential for normal cardiac function, maintenance of mitochondrial iron homeostasis and maturation of cytosolic Fe/S proteins. In summary, this report provides characterization of a protein involved in mitochondrial iron export.     

Reduction of 4-nitrophenol and 2-nitroaniline using immobilized CoMn2O4 NPs on lignin supported on FPS

In the present work, fibrous phosphosilicate (FPS) was functionalized by using octakis[3-(3-aminopropyltriethoxysilane)propyl]octasilsesquioxane (APTPOSS) groups that act as strong performers. In this regard, the nanoparticles of CoMn₂O₄ were dispersed, properly, on FPS microsphere (CoMn₂O₄/APTPOSS@FPS) fibers. Agricultural and industrial waste waters contain nitrophenols. They are amongst the most common organic pollutants. In water, low concentrations are harmful to human health and aquatic life owing to the potential mutagenic and carcinogenic influences of nitrophenols. 4-Nitrophenol (4-NP), as well as 2-nitroaniline (2-NA), are known hazardous toxic waste contaminants and are included in the United States Environmental Protection Agency (USEPA) list. Thus, to eliminate them, novel methods are necessary. In addition, o-phenylenediamine (o-PDA) and 4-aminophenol (4-AP) are considered as significant intermediates for the synthesis of dyes and drugs, which are synthesized from 2-NA and 4-NP. Nanoparticles of CoMn₂O₄/APTPOSS@FPS utilized for the reduction of 2-NA and 4-NP, increase the efficiency of the reaction with considerable chemoselectivity. The results showed that the P and O atoms of lignin-FPS gold nanoparticles (NPs) were stable and the morphology and structure of FPS increased the catalytic activity.

In the present work, fibrous phosphosilicate (FPS) is functionalized by using octakis[3(3-aminopropyltriethoxysilane)propyl]octasilsesquioxane (APTPOSS) groups.