The cross-cultural adaptation of the disability of arm, shoulder and hand (DASH): a systematic review

A systematic review of cross-cultural adaptations of the Disability of Arm, Shoulder and Hand into other languages was undertaken focusing on the translation and adaptation process, the problems during the translation process and proposed solutions. Nine articles were selected for analysis. All were written in English and addressed the qualitative issues of the cross-cultural adaptation process. The results demonstrated strong evidence that translation, adaptation and technical issues are most influential in the cross-cultural adaptation process. Awareness, understanding and incorporation of these issues will assist in future translations and adaptations of occupational therapy evaluation tools for use in other countries with different cultures. Implications for occupational therapy education, practice and research are discussed.     

External urethral stenosis: a latent effect of sulfur mustard two decades post-exposure

Background  Sulfur mustard (SM), a chemical weapon used widely during World War I and against Iranians during the Iran–Iraq War of the 1980s, causes massive inflammatory tissue damage in the immediate post-exposure period, resulting in debilitating chronic disease in years to decades following contact with the agent. These syndromes most often are pathologies of the lungs, eyes, and skin, the primary target organs of SM. Typically, they are characterized by severe and increasingly painful inflammation, often accompanied by fibrosis and constriction of the anatomic channels needed for normal life, such as the small airways of the lungs and, in the present report, the urethra.
Methods  The present case study is a 43-year-old man with a history of heavy SM exposure to the groin in 1984.
Result  Within 1 year after exposure, the patient was found to have developed meatal stricture, occlusion of the external urethral meatus, and difficulty in urination. Two years post-exposure, he underwent ventral meatotomy and meatoplasty.
Conclusion  This case presents a unique example of the latent effects of SM exposure to the groin, and will be of value in the prevention of similar injury and complications to persons at risk of SM exposure in the future.     

Vascular dysfunction measured by fingertip thermal monitoring is associated with the extent of myocardial perfusion defect

Background  Previous studies have shown that vascular dysfunction measured by digital thermal monitoring (DTM) during an arm-cuff reactive hyperemia procedure correlates with the severity of coronary artery disease measured by coronary artery calcium in asymptomatic patients. Current study investigates the correlation between DTM and abnormal myocardial perfusion imaging (MPI). Methods  About 116 consecutive patients with chest discomfort, age 57 ± 10 years, underwent MPI, DTM and Framingham Risk Score (FRS) assessment. Fingertip temperature rebound (TR), DTM index of vascular reactivity, was assessed after a 2-minute arm-cuff reactive hyperemia test. The extent of myocardial perfusion defect was measured by summed stress score (SSS). Results  TR decreased from SSS < 4 (1.61 ± 0.15) to 4 ≤ SSS ≤ 8 (0.5 ± 0.22) to 9 ≤ SSS ≤ 13 (0.26 ± 0.15) to SSS > 13 (−0.37 ± 0.19) (P = .0001). After adjusting for cardiac risk factors, the odds ratio of the lowest versus two upper tertiles of TR was 3.93 for SSS ≥ 4 and 9.65 for SSS ≥ 8 compared to SSS < 4. TR correlated well with SSS (r = −0.88, P = .0001). Addition of TR to FRS increased the area under the ROC curve to predict abnormal MPI, SSS ≥ 4, from 0.65 to 0.84 (P < .05). Conclusion  Vascular dysfunction measured by DTM is associated with the extent of myocardial perfusion defect independent of age, gender, and cardiac risk factors. Electronic supplementary material  The online version of this article (doi:) contains supplementary material, which is available to authorized users.     

Improved bioluminescence and fluorescence reconstruction algorithms using diffuse optical tomography, normalized data, and optimized selection of the permissible source region

Reconstruction algorithms are presented for two-step solutions of the bioluminescence tomography (BLT) and the fluorescence tomography (FT) problems. In the first step, a continuous wave (cw) diffuse optical tomography (DOT) algorithm is used to reconstruct the tissue optical properties assuming known anatomical information provided by x-ray computed tomography or other methods. Minimization problems are formed based on L1 norm objective functions, where normalized values for the light fluence rates and the corresponding Green's functions are used. Then an iterative minimization solution shrinks the permissible regions where the sources are allowed by selecting points with higher probability to contribute to the source distribution. Throughout this process the permissible region shrinks from the entire object to just a few points. The optimum reconstructed bioluminescence and fluorescence distributions are chosen to be the results of the iteration corresponding to the permissible region where the objective function has its global minimum This provides efficient BLT and FT reconstruction algorithms without the need for a priori information about the bioluminescence sources or the fluorophore concentration. Multiple small sources and large distributed sources can be reconstructed with good accuracy for the location and the total source power for BLT and the total number of fluorophore molecules for the FT. For non-uniform distributed sources, the size and magnitude become degenerate due to the degrees of freedom available for possible solutions. However, increasing the number of data points by increasing the number of excitation sources can improve the accuracy of reconstruction for non-uniform fluorophore distributions.     

Evaluation of the effects of Salvia hypoleuca on the cAMP-responsive element modulator (CREM) gene expression and spermatogenesis in rat

ObjectiveSalvia species which are medicinal herbs have been used to improve male reproductive functions in traditional medicine. They also, have been used to treat several diseases. In this present study, effects of Salvia hypoleuca on male rat reproductive function were investigated by sperm analysis and assessment of CREM expression at mRNA and protein levels.Materials and methodsTwo hundred and fifty mg/kg/day of S. hypoleuca as treatment was given to 10-week old male wistar rats for 56 consecutive days. Sperm analysis, RT-PCR and western blot were carried out to investigate rat reproductive function.ResultsResults indicated significant increase in the weights of testis, epididymal sperm counts, and sperm motility compared to control group. RT-PCR and western blot showed an increase in the expression of both CREM mRNA and protein levels.ConclusionThe findings in this study showed S. hypoleuca induced spermatogenesis by CREM activation in testis and improved male fertility.     

Outcome of pediatric renal transplantation in Labfi Nejad Hospital, Tehran, Iran

Kidney transplantation is the treatment of choice for children with end-stage renal disease. In Iran, a kidney transplantation program was started in the Labfi Nejad Hospital, Tehran in 1985. From 1985 to 2003, 278 children (mean age 11.6 years, 59.7% males) received their first renal transplant. All transplants were donations from live donors (12.5% live-related donors); 30.8% of patients were preemptively transplanted. The overall 1-year patient survival rate was 92% and the 5-year survival rate 74%. The median graft survival time was 7.2 years. The rate of graft survival was 88.8% at 1 year, 77% at 3 years, 67% at 5 years, 50% at 7 years, and 43% at 10 years after transplantation. The survival rate of patients and transplants improved significantly with time (p<0.05). In patients transplanted before 1997, the 5-year graft survival was 50% and 82% in patients transplanted after 1997. At the same time intervals, the frequency of acute rejection episodes was 66.6 versus 40.8% and of chronic rejection 50.5 versus 28.7%. The outcome in children below the age of 6 years was poor. Graft survival was negatively correlated with the frequency and an early time point of acute rejection episodes. The modus of transplantation (preemptive or postdialysis) did not influence the results. In conclusion, patient and graft survival in transplanted children significantly improved with time, thus reflecting greater medical and surgical experience, new immunosuppressive drugs, and better compliance.     

A radiographic technique for the assessment of ankle and midfoot equinus

BACKGROUND: Both clinical and radiographic techniques have been used to evaluate foot and ankle position and orientation. Clinical measurements have been shown to be less reliable than radiographic measurements. Because midfoot equinus deformity may coexist with ankle joint equinus deformity, a radiographic method of separating and measuring these two components is desirable. The purpose of this study was to evaluate a new radiographic technique, the Lateral Mid-Tibia to Toes (LMTT), weightbearing view of the foot and ankle. METHOD: Twenty LMTT images were randomly selected from the study population of patients treated in our center for lower limb equinus deformity. Validation was achieved by a study involving three observers, assessing 20 images on two consecutive occasions, 4 weeks apart. Analysis was performed using Kappa statistics. RESULTS: The plantigrade and midfoot equinus angles provided substantial (p = 0.000) and moderate (p = 0.005) agreement, respectively. CONCLUSIONS: Awareness of midfoot equinus and its correction may avoid residual deformity when surgery is performed to correct equinus deformity of the ankle.