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11.
Legese Chelkeba Arezoo Ahmadi Mohammad Abdollahi Atabak Najafi Mojtaba Mojtahedzadeh 《Indian Journal of Critical Care Medicine》2015,19(7):401-411
Introduction:
Survival sepsis campaign guidelines have promoted early goal-directed therapy (EGDT) as a means for reduction of mortality. On the other hand, there were conflicting results coming out of recently published meta-analyses on mortality benefits of EGDT in patients with severe sepsis and septic shock. On top of that, the findings of three recently done randomized clinical trials (RCTs) showed no survival benefit by employing EGDT compared to usual care. Therefore, we aimed to do a meta-analysis to evaluate the effect of EGDT on mortality in severe sepsis and septic shock patients.Methodology:
We included RCTs that compared EGDT with usual care in our meta-analysis. We searched in Hinari, PubMed, EMBASE, and Cochrane central register of controlled trials electronic databases and other articles manually from lists of references of extracted articles. Our primary end point was overall mortality.Results:
A total of nine trails comprising 4783 patients included in our analysis. We found that EGDT significantly reduced mortality in a random-effect model (RR, 0.86; 95% confidence interval [CI], 0.72–0.94; P = 0.008; I2 =50%). We also did subgroup analysis stratifying the studies by the socioeconomic status of the country where studies were conducted, risk of bias, the number of sites where the trials were conducted, setting of trials, publication year, and sample size. Accordingly, trials carried out in low to middle economic income countries (RR, 0.078; 95% CI, 0.67–0.91; P = 0.002; I2 = 34%) significantly reduced mortality compared to those in higher income countries (RR, 0.93; 95% CI, 0.33–1.06; P = 0.28; I2 = 29%). On the other hand, patients receiving EGDT had longer length of hospital stay compared to the usual care (mean difference, 0.49; 95% CI, –0.04–1.02; P = 0.07; I2 = 0%).Conclusion:
The result of our study showed that EGDT significantly reduced mortality in patients with severe sepsis and septic shock. Paradoxically, EGDT increased the length of hospital stay compared to usual routine care. 相似文献12.
Mojtaba Jafari Hossein Rafiei Asra Nassehi Farzaneh Soleimani Mansuor Arab Mohammad Reza Noormohammadi 《Indian Journal of Palliative Care》2015,21(2):192-197
Background:
Education about caring for dying patients could be effective in changing nursing students’ attitude toward caring for dying patients.Aim:
The aim of the present study was to examine the nursing students’ attitude toward caring for dying patients and effects of education on their attitude.Materials and Methods:
The present study enjoys a quasi-experimental method with using one-group pre-test/post-test design conducted in Bam in southeast of Iran. The attitude of nursing students was measured using Frommelt Attitude Toward Care of the Dying (FATCOD) scale before and after an educational intervention. Data were analyzed using non-parametric tests in Statistical Package for the Social Sciences (SPSS) 18 software.Results:
Of 32 students, 30 participated in this study (response rate of 94%). Only 20% of the students reported previous experience of dying patients in their clinical courses. Students showed moderately negative to neutral attitudes toward caring for dying patients. Education has improved students’ attitude significantly (mean score of FATCOD before study were 3.5 ± 0.43 and after intervention were 4.7 ± 0.33) (P < 0.001).Conclusion:
Educational programs about death and caring for dying patients should be added to undergraduate nursing curricula. Further research recommended examining nursing students’ knowledge about caring for dying patients and the effect of education on their knowledge. 相似文献13.
Parsa Yousefichaijan Ali Cyrus Fatemeh Dorreh Mohammad Rafeie Mojtaba Sharafkhah Faryar Frohar Fatemeh Safi 《Iranian journal of pediatrics.》2015,25(6)
Background:
Nephrolithiasis in children is associated with a high rate of complications and recurrence.Objectives:
Since some evidences reported that zinc has an important place amongst inhibitors of crystallization and crystal growth, we decided to assess the effectiveness of oral zinc sulfate as adjuvant treatment in children with nephrolithiasis.Patients and Methods:
This was a randomized, double-blind, placebo-controlled clinical trial. 102 children in the age range 1 month to 11 years with first nephrolithiasis were recruited. Patients were randomly divided into two equal groups (intervention and control groups). Intervention group received conservative measures for stones and 1 mg/kg/day (maximum 20 mg/day) oral zinc sulfate syrup for 3 months. Control group received placebo in addition to conservative measures, also for 3 months. Patients were followed up by ultrasonography for 9 months, in 5 steps (at the end of 1st, 2nd, 3rd, 6th and 9th month after treatment) assessing size and number of stones in the kidneys.Results:
Only at the end of the first month, the average number (intervention: 1.15 ± 3.78, control: 1.3 ± 2.84) (P = 0.001) and size (cm) (intervention: 0.51 ± 1.76, control: 0.62 ± 1.39) (P = 0.001) of stones was significantly lower in the intervention group, and in other points there was no significant therapeutic efficacy in oral zinc adjuvant treatment compared to conservative treatment alone. Also, during the 9-month follow-up, the number and size of stones in both groups decreased significantly (both: P < 0.0001) in a way that the decrease in the intervention group showed no difference with the control group.Conclusions:
Adjuvant treatment with zinc is not more effective than consecutive treatment in children with nephrolithiasis. However, further studies are recommended due to the lack of clinical evidence in this field. 相似文献14.
Mojtaba Babaei-Mobarakeh Amir Letafatkar Amir Hosein Barati Zohre Khosrokiani 《Journal of bodywork and movement therapies》2018,22(4):1013-1021
Background
Rehabilitation of injuries in the upper extremity and reestablishment of muscle strength throughout the range of motion in overhead movements, are the major concerns of athletes and coaches in the sports field.Purpose
To determine the effect of eight-week “gyroscopic device” mediated resistance training exercise on grip strength, wrist and shoulder strength and proprioception, and upper extremity performance, in participants with impingement syndrome or tennis elbow.Design and methods
For this study, in a university rehabilitation clinic 45 volleyball players (aged 22–28) purposefully were selected and divided into 3 groups: shoulder impingement (group I), tennis elbow (group II), and control (group III). The experimental groups performed the “gyroscopic device” mediated resistance training, three sessions a week over 8 wks. Grip strength, wrist and shoulder strength and proprioception, and upper extremity performance were measured before and after implementation of the intervention (eight-week resistance training using a “gyroscopic device”) using a hand hold dynamometer, isokinetic dynamometer, and Y balance test respectively.Results
After 8 weeks of “gyroscopic device” exercise, improvement in the shoulder, wrist and grip strength, shoulder and wrist proprioception and performance scores of both experimental groups was significant. There were no significant differences between study groups I and II, both groups, however, demonstrated significant differences when compared to the control group, but between group I and the control group, and between group II and the control group, the difference was significant. However, no significant change was seen in the control group.Conclusions
Due to the significant effects of the “gyroscopic device” mediated exercise on grip strength, wrist and shoulder strength and proprioception, and performance of the upper extremity, use of the exercise can be recommended for subjects with impingement syndrome or tennis elbow impairment in measured variables. More research is needed to confirm the result of this study. 相似文献15.
16.
17.
Seyed Mojtaba Hosseini Attiyeh Vasaghi Newsha Nakhlparvar Reza Roshanravan Tahereh Talaei-khozani Zahra Razi 《中国神经再生研究》2015,10(8):1312-1316
Alginate scaffold has been considered as an appropriate biomaterial for promoting the differentiation of embryonic stem cells toward neuronal cell lineage. We hypothesized that alginate scaffold is suitable for culturing Wharton's jelly mesenchymal stem cells(WJMSCs) and can promote the differentiation of WJMSCs into neuron-like cells. In this study, we cultured WJMSCs in a three-dimensional scaffold fabricated by 0.25% alginate and 50 m M Ca Cl2 in the presence of neurogenic medium containing 10 μM retinoic acid and 20 ng/m L basic fibroblast growth factor. These cells were also cultured in conventional two-dimensional culture condition in the presence of neurogenic medium as controls. After 10 days, immunofluorescence staining was performed for detecting β-tubulin(marker for WJMSCs-differentiated neuron) and CD271(motor neuron marker). β-Tubulin and CD271 expression levels were significantly greater in the WJMSCs cultured in the three-dimensional alginate scaffold than in the conventional two-dimensional culture condition. These findings suggest that three-dimensional alginate scaffold cell culture system can induce neuronal differentiation of WJMSCs effectively. 相似文献
18.
Seyed Mojtaba Hosseini Mohammad Farahmandnia Zahra Razi Somayeh Delavarifar Benafsheh Shakibajahromi 《中国神经再生研究》2015,10(6):904-908
Cell therapy using stem cell transplantation against cerebral ischemia has been reported. However, it remains controversial regarding the optimal time for cell transplantation and the transplantation route. Rat models of cerebral ischemia were established by occlusion of the middle cerebral artery. At 1, 12 hours, 1, 3, 5 and 7 days after cerebral ischemia, bone marrow mesenchymal stem cells were injected via the tail vein. At 28 days after cerebral ischemia, rat neurological function was evaluated using a 6-point grading scale and the pathological change of ischemic cerebral tissue was observed by hematoxylin-eosin staining. Under the fluorescence microscope, the migration of bone marrow mesenchymal stem cells was examined by PKH labeling. Caspase-3 activity was measured using spectrophotometry. The optimal neurological function recovery, lowest degree of ischemic cerebral damage, greatest number of bone marrow mesenchymal stem cells migrating to peri-ischemic area, and lowest caspase-3 activity in the ischemic cerebral tissue were observed in rats that underwent bone marrow mesenchymal stem cell transplantation at 12 hours after cerebral ischemia. These findings suggest that 12 hours after cerebral ischemia is the optimal time for tail vein injection of bone marrow mesenchymal stem cell transplantation against cerebral ischemia, and the strongest neuroprotective effect of this cell therapy appears at this time. 相似文献
19.
Mohammad Reza Alizadeh John T. Abatzoglou Charles H. Luce Jan F. Adamowski Arvin Farid Mojtaba Sadegh 《Proceedings of the National Academy of Sciences of the United States of America》2021,118(22)
Increases in burned area and large fire occurrence are widely documented over the western United States over the past half century. Here, we focus on the elevational distribution of forest fires in mountainous ecoregions of the western United States and show the largest increase rates in burned area above 2,500 m during 1984 to 2017. Furthermore, we show that high-elevation fires advanced upslope with a median cumulative change of 252 m (−107 to 656 m; 95% CI) in 34 y across studied ecoregions. We also document a strong interannual relationship between high-elevation fires and warm season vapor pressure deficit (VPD). The upslope advance of fires is consistent with observed warming reflected by a median upslope drift of VPD isolines of 295 m (59 to 704 m; 95% CI) during 1984 to 2017. These findings allow us to estimate that recent climate trends reduced the high-elevation flammability barrier and enabled fires in an additional 11% of western forests. Limited influences of fire management practices and longer fire-return intervals in these montane mesic systems suggest these changes are largely a byproduct of climate warming. Further weakening in the high-elevation flammability barrier with continued warming has the potential to transform montane fire regimes with numerous implications for ecosystems and watersheds.Fire is an integral component of most forested lands and provides significant ecological services (1). However, burned area, fire size, the number of large fires, and the length of fire season have increased in the western United States in recent decades (2, 3). Increasing fire activity and the expansion of wildland urban interface (4) collectively amplified direct and indirect fire-related loss of life and property (5, 6) and contributed to escalating fire suppression costs (7). While increased biomass due to a century of fire exclusion efforts is hypothesized to have partially contributed to this trend (8), climate change is also implicated in the rise of fire activity in the western United States (9–11).Although increases in forest fire activity are evident in all major forested lands in the western United States (2, 12, 13), an abundance of moisture—due to snowpack persistence, cooler temperatures, and delayed summer soil and fuel drying—provides a strong buffer of fire activity (13) and longer fire-return intervals (14) at high elevations. Recent studies, however, point to changing fire characteristics across many ecoregions of the western United States (15), including high-elevation areas of the Sierra Nevada (16), Pacific Northwest, and Northern Rockies (12, 17). These studies complement documented changes in montane environments including amplified warming with elevation (18), widespread upward elevational shift in species (19), and increased productivity in energy-limited high-elevation regions that enhance fuel growth and connectivity (20). These changes have been accompanied by longer snow-free periods (21), increased evaporative demand (9), and regional declines in fire season precipitation frequency (11) across the western United States promoting increased fuel ignitability and flammability that have well-founded links to forest burned area. A warmer climate is also conducive to a higher number of convective storms and more frequent lightning strikes (22).In this study, we explore changes in the elevational distribution of burned forest across the western United States and how changes in climate have affected the mesic barrier for high-elevation fire activity. We focus on changes in high-elevation forests that have endured fewer direct anthropogenic modifications compared to drier low-elevation forests that had frequent low-severity fires prior to European colonization and have been more subject to changes in settlement patterns as well as fire suppression and harvest (23, 24); we also pose the following questions: 1) Has the elevational distribution of fire in the western US forests systematically changed? and 2) What changes in biophysical factors have enabled such changes in high-elevation fire activity? We explore these questions across 15 mountainous ecoregions of the western United States using records from large fires (>405 ha) between 1984 and 2017 [Monitoring Trends in Burn Severity (MTBS) (25)], a 10-m–resolution digital elevation model, and daily high-spatial–resolution surface meteorological data [gridMET (26)].We focus on the trends in Z90—defined as the 90th percentile of normalized annual elevational distribution of burned forest in each ecoregion. Here, the term “normalized” essentially refers to the fraction of forest area burned by elevation. We complement this analysis by examining trends in burned area by elevational bands and using quantile regression of normalized annual forest fire elevation. We then assess the interannual relationships between Z90 and vapor pressure deficit (VPD) and compare the upslope advance in montane fire to elevational climate velocity of VPD during 1984 to 2017. Specifically, we use VPD trends and VPD–high-elevation fire regression to estimate VPD-driven changes in Z90 and BA90— defined as annual burned area above the 90th percentile of forest elevational distribution in each ecoregion—during 1984 to 2017. 相似文献