Acetaminophen use and the symptoms of asthma, allergic rhinitis and eczema in children

Allergic diseases are frequent in children and their prevalence and severity differ in the different regions of the world. A number of studies have been performed to determine the factors which are effective in the incidence of these diseases. One of the drugs that might have a role in incidence or intensity of the symptoms of allergic diseases is Acetaminophen. In our survey conducted with standardized method (International Study of Asthma and Allergies in Childhood), 3000 children 6-7 years old and 3000 teenagers 13-14 years old were questioned regarding asthma, allergic rhinitis and eczema. The prevalence of ever wheezing in the children of 6-7 years old who took acetaminophen in the first year of their life was 11.3%, which is more than other group (Odds Ratio=1.54, 95% Confidence Interval: 1-2.38, P=0.049) and the prevalence of ever wheezing in older age group who have taken acetaminophen at least once in a month was 25.1% which is more than those taken less acetaminophen (OR=1.7, 95%CI=1.43-2.04, P=0.000). Moreover taking more acetaminophen during past 12 months led to more prevalence of night dry coughs and the symptoms of rhinitis in children 6-7 years old and eczema and rhinitis symptoms in the 13-14 years old. Our findings suggest that taking more acetaminophen may be associated with increasing allergic symptoms in children.     

Iranian staff nurses' views of their productivity and management factors improving and impeding it: a qualitative study

As the biggest proportion of hospital personnel, Iranian nurses have a major role in providing quality care to patients. Nursing managers and nurses no longer feel that nurses' work is valued and they are concerned about their productivity. Nurses' views about productivity and management factors affecting it have been identified as the most important aspects affecting productivity. Thus, this study assesses productivity from the nurse's view. A grounded theory approach was used for this research. Purposive sampling and semistructured interviews were used. The data were analyzed using constant comparative analysis. Most participants felt that the qualitative nature (effectiveness) of productivity is very important. Also, participants indicated that management is the most important factor that can promote or impede their productivity. They suggested that managers' performance and their skill level are the factors influencing productivity. Effective management can improve nurses' productivity and the quality of care that nurses provide.     

Analysis of opium use by students of medical sciences

Aims and objectives. To investigate the prevalence of opium use in university students. Background. University health professionals and authorities are very concerned about substance use among university students. Design. A survey with a representative sample of 2519 (1126 men and 1393 women) university students and opium use disorders assessed by means of DSM‐IV criteria (Diagnostic Statistical Manual‐IV Axis I during the year 2003). Findings. Mean age of the sample was 23·8 year and SD was 3·9. Of the students, 110 (4·4%) admitted using of opium once or more during their lives (9.1% of men and 0·6% of women; P < 0·01). Fifty (2%) were occasional opium user (4·2% of men and 0·2% of women; P < 0·01). Nineteen (0·8%) were current opium user (1·4% of men and 0·2% of women; P = 0·001). Mean age of opium users was higher than the remainder. Opium use was significantly related to gender (P = 0·001), and life stress (P = 0·04). Conclusion. These findings can be considered for preventive and therapeutic programmes, because early intervention during the formative university years may present an opportunity to reduce the risk of long‐term problems, to decrease social and individual harm and also to promote public health of society. Relevance to clinical practice. These findings can be considered in clinical practice for detection and treatment of opioid abuse.     

Comparison of Fasting Glucose with Post-Load Glucose Values and Glycated Hemoglobin for Prediction of Type 2 Diabetes: The Isfahan Diabetes Prevention Study

OBJECTIVES: The aim of this study was to compare the ability of fasting plasma glucose (FPG), post-load plasma glucose values and glycated hemoglobin (HbA1c) to predict progression to diabetes in non-diabetic first-degree relatives (FDR) of patients with type 2 diabetes. METHODS: A total of 701 non-diabetic FDR of diabetic patients aged 20-70 years surveyed in 2003 to 2005 were followed until 2008 for the onset of type 2 diabetes mellitus. At baseline and at follow-ups, participants underwent a standard 75 g 2-hour oral glucose tolerance test (OGTT). Prediction of progression to type 2 diabetes was assessed by using area under the receiver-operating characteristic (ROC) curves based upon measurement of FPG, post-load glucose values and HbA1c. RESULTS: The incidence of type 2 diabetes was 33.9 per 1000 person-years in men and 48.6 in women. The incidence rates were 4.6, 50.7, and 99.7 per 1000 person-years in FDR with normal glucose tolerance, impaired fasting glucose and impaired glucose tolerance respectively. FPG value was a better predictor of progression to diabetes than any post-load glucose values or HbA1c. The areas under the ROC curves were 0.811 for fasting, 0.752 for 1/2-hour, 0.782 for 1-hour and 0.756 for 2-hour glucose vs. 0.634 for HbA1c (p < 0.001). CONCLUSIONS: FPG had more discriminatory power to distinguish between individuals at risk for diabetes and those who were not at risk than post-load glucose values during OGTT or HbA1c. Our findings support the American Diabetes Association recommendation of using FPG concentration to diagnose diabetes.     

Effect of ethnic origin (Caucasians versus Turks) on the prevalence of rheumatic diseases: a WHO-ILAR COPCORD urban study in Iran

The objective of this study was to compare the prevalence of musculoskeletal complaints and rheumatic disorders in Caucasians and Turks in an identical environment. Subjects were selected randomly for an interview from Tehran’s 22 districts. The Community Oriented Program for Control of Rheumatic Diseases questionnaire was filled in, positive cases were examined, and if needed, laboratory or X-ray tests were performed. A total of 4,096 houses were visited, and 10,291 persons were interviewed. They were 71.4% Caucasians and 23.1% Turks with similar distribution of age and gender. Musculoskeletal complaints of the past 7 days were detected in 40.8% of Caucasians and 45.5% of Turks (p?<?0.001). In Caucasians, the total of musculoskeletal complaints in men was 33.8% (95% CI, 31.4–36.2%) versus 48.3% in women (95% CI, 45.7–50.8%). In Turks, the total of musculoskeletal complaints in men was 36.6% (95% CI, 32.2–41.1%) versus 55.8% in women (95% CI, 55.8–60.6%). The data of Caucasians versus Turks were as follows: knee pain 20.2% (95% CI, 18.2–22.1) versus 24.1% (95% CI, 20.5–27.6), with p?<?0.001; dorso-lumbar spine pain 15.1% (95% CI, 13.6–16.6) versus 18.4% (95% CI, 15.1–21.8), with p?<?0.001; shoulder pain 10.7% (95% CI, 9.4–11.9) versus 12.3% (95% CI, 9.7–14.8), with p?=?0.025; osteoarthritis 14.1% (95% CI, 12.8–15.2) versus 16.4% (95% CI, 14.3–18.6), p?=?0.04; and knee osteoarthritis 12.3% (95% CI, 11.8–14.1) versus 15.3% (95% CI, 13.3–17.4), with p?<?0.001). There were no significant differences regarding the prevalence of soft tissue rheumatism, rheumatoid arthritis, ankylosing spondylitis, Behcet’s disease, fibromyalgia, and gout. Although musculoskeletal complaints were more frequent in Turks than in Caucasians, the prevalence of rheumatic disorders was rather similar except for knee osteoarthritis.     

Male reproductive impacts of styrene in rat

To determine the effect of styrene on the male reproductive function of rats, male Wistar rats received a daily intraperitoneal (ip) injection of the xenobiotic at a dose of 600 mg/kg body weight. Serum testosterone (T) level was measured in duplicate by radioimmunoassay (RIA). Blood luteinizing hormone (LH) and follicle stimulating hormone (FSH) concentrations were determined using enzyme-linked immunosorbent assay (ELISA). After 10 days of treatment, an increase of the relative weight of the testis occurred, but that of the seminal vesicles and prostate remained unchanged compared to controls injected with an equivalent volume of the vehicle (corn oil). Serum T concentration dropped, while serum hypophyse hormone levels increased. Testicular histological observations revealed a pronounced morphological alteration, with enlarged intracellular spaces, loosening of tissue, and dramatic loss of gametes in the lumen of the seminiferous tubules. Spermatogenesis damage was also confirmed by the decrease in motility and the number of epididymal spermatozoa of treated rats. According to these results, with regard to the lack of a dose response relationship in this study, we may conclude that the testis, precisely the germinal and Sertoli cells, are the major targets for styrene toxicity.     

Post-revascularization Ejection Fraction Prediction for Patients Undergoing Percutaneous Coronary Intervention Based on Myocardial Perfusion SPECT Imaging Radiomics: a Preliminary Machine Learning Study

In this study, the ability of radiomics features extracted from myocardial perfusion imaging with SPECT (MPI-SPECT) was investigated for the prediction of ejection fraction (EF) post-percutaneous coronary intervention (PCI) treatment. A total of 52 patients who had undergone pre-PCI MPI-SPECT were enrolled in this study. After normalization of the images, features were extracted from the left ventricle, initially automatically segmented by k-means and active contour methods, and finally edited and approved by an expert radiologist. More than 1700 2D and 3D radiomics features were extracted from each patient’s scan. A cross-combination of three feature selections and seven classifier methods was implemented. Three classes of no or dis-improvement (class 1), improved EF from 0 to 5% (class 2), and improved EF over 5% (class 3) were predicted by using tenfold cross-validation. Lastly, the models were evaluated based on accuracy, AUC, sensitivity, specificity, precision, and F-score. Neighborhood component analysis (NCA) selected the most predictive feature signatures, including Gabor, first-order, and NGTDM features. Among the classifiers, the best performance was achieved by the fine KNN classifier, which yielded mean accuracy, AUC, sensitivity, specificity, precision, and F-score of 0.84, 0.83, 0.75, 0.87, 0.78, and 0.76, respectively, in 100 iterations of classification, within the 52 patients with 10-fold cross-validation. The MPI-SPECT-based radiomic features are well suited for predicting post-revascularization EF and therefore provide a helpful approach for deciding on the most appropriate treatment.

     

The impact of hybrid immunity on immune responses after SARS-CoV-2 vaccination in persons with multiple sclerosis treated with disease-modifying therapies

Background and purpose

Hybrid immunity to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) develops from a combination of natural infection and vaccine-generated immunity. Multiple sclerosis (MS) disease-modifying therapies (DMTs) have the potential to impact humoral and cellular immunity induced by SARS-CoV-2 vaccination and infection. The aims were to compare antibody and T-cell responses after SARS-CoV-2 mRNA vaccination in persons with MS (pwMS) treated with different DMTs and to assess differences between naïvely vaccinated pwMS and pwMS with hybrid immunity vaccinated following a previous SARS-CoV-2 infection.

Methods

Antibody and T-cell responses were determined in pwMS at baseline and 4 and 12 weeks after the second dose of SARS-CoV-2 vaccination in 143 pwMS with or without previous SARS-CoV-2 infection and 40 healthy controls (HCs). The MS cohort comprised natalizumab (n = 22), dimethylfumarate (n = 23), fingolimod (n = 38), cladribine (n = 30), alemtuzumab (n = 17) and teriflunomide (n = 13) treated pwMS. Immunoglobulin G antibody responses to SARS-CoV-2 antigens were measured using a multiplex bead assay and FluoroSpot was used to assess T-cell responses (interferon γ and interleukin 13).

Results

Humoral and T-cell responses to vaccination were comparable between naïvely vaccinated HCs and pwMS treated with natalizumab, dimethylfumarate, cladribine, alemtuzumab and teriflunomide, but were suppressed in fingolimod-treated pwMS. Both fingolimod-treated pwMS and HCs vaccinated following a previous SARS-CoV-2 infection had higher antibody levels 4 weeks after vaccination compared to naïvely vaccinated individuals. Antibody and interferon γ levels 12 weeks after vaccination were positively correlated with time from last treatment course of cladribine.

Conclusion

These findings are of relevance for infection risk mitigation and for vaccination strategies amongst pwMS undergoing DMT.     

Hybrid approach for harmony transcatheter pulmonary valve replacement

The Harmony™ Transcatheter Pulmonary Valve (Medtronic) was recently approved by the Food and Drug Administration for transcatheter pulmonary valve replacement in native right ventricular outflow tracts. Despite this milestone, some patients have main pulmonary arteries that are severely dilated and continue to require surgical pulmonary valve replacement. The hybrid approach combines surgical creation of a landing zone, transcatheter valve deployment, and suture stabilization of the implanted valve. In this case series, we report the first use of a hybrid approach for Harmony™ transcatheter pulmonary valve replacement. Two cases are reported with varying approaches for surgical creation of a landing zone followed by successful placement of a Harmony™ valve.