Soft tissue distraction using pentagonal frame for long-standing traumatic flexion deformity of interphalangeal joints

Objective:Interphalangeal joint contracture is a challenging complication of hand trauma,which reduces the functional capacity of the entire hand.In this study we evaluated the results of soft tissue d...     

The trend of burn mortality in Iran — A study of fire,heat and hot substance-related fatal injuries from 1990 to 2015

Introduction

Burn injuries are a major cause of preventable mortality worldwide. To implement preventive strategies, a detailed understanding of the rate and trend of fatal burn injuries is needed. The aim of this study was to determine the rate and trend of burn mortality at national and province level in Iran from 1990 to 2015.

Mental health in patients with pemphigus: an issue to worth consideration

Background:

There exists a high prevalence of psychiatric disorders in dermatological patients. Although, investigators have evaluated psychiatric aspects of the patients suffering from skin diseases; there are rare studies concerning mental health in pemphigus patients. The objective of this study was to evaluate mental health status and quality of life of newly diagnosed pemphigus patients.

Materials and Methods:

Between April 2007 and June 2008, all newly diagnosed pemphigus patients attending the outpatient clinic of a dermatological hospital were given a questionnaire comprising the GHQ-28 and DLQI to fill out.

Results:

Of 283 patients, 212 complete forms were returned. The bimodal score of GHQ ranged from 0 to 26 (Mean = 9.4) and the Likert score of GHQ ranged from 6 to 68 (Mean = 31.9). The DLQI score ranged between 0 and 30 (Mean of 13.8). A total of 157 patients (73.7%) were yielded to be possible cases of mental disorder considering GHQ-28 bimodal scores. Significant correlation was detected between the DLQI score and bimodal and Likert scoring of GHQ-28.

Conclusion:

Our study has depicted high prevalence of psychiatric comorbidity in pemphigus patients. It underlines the fact that physicians, who are in-charge of care for these patients, are in an exceptional position to distinguish the psychiatric comorbidity and to take appropriate measures.     

Different Pain States of Trigeminal Neuralgia Make Significant Changes in the Plasma Proteome and Some Biochemical Parameters: a Preliminary Cohort Study

Trigeminal neuralgia (TN) with chronic and severe neuropathic pain leads to remarkable interference in daily living activities of patients. Unknown molecular mechanisms involved in TN pathophysiology are a challenge for complete treatment of the disease. The present study was conducted to investigate changes in the plasma proteome beside biochemical parameters, including calcitonin gene-related peptide (CGRP), nitric oxide (NO), amino acids, and vitamin D (Vit D) in different pain states in TN patients. Plasma samples were obtained from the control group (#13) and patients with purely paroxysmal type of classical TN (#13) before and after microvascular decompression (MVD). We analyzed plasma proteome using two-dimensional gel electrophoresis (2-DE) and identified altered proteins by applying MALDI–TOF/TOF mass spectrometry. The plasma levels of neurotransmitters (CGRP, NO, and amino acids) and Vit D were investigated by ELISA and liquid chromatography-tandem mass spectrometry (LC-MS/MS). The pain-rating index (PRI) was specified using a McGill pain questionnaire, which indicated a significant pain reduction after MVD. Plasma proteome analysis showed upregulated expression of transthyretin (TTR), retinol-binding protein 4 (RBP4), and alpha-1-acid glycoprotein 2 (AGP2) in TN patients compared to control group; whereas, TTR and RBP expression was downregulated after surgery. Moreover, the elevated NO and CGRP and decreased Vit D concentrations were observed in patients. After surgery, NO, Arg, Cit, and Gly levels were decreased along with pain relief. Our findings support the role of altered proteins in TN pathophysiology and suggest involvement of the evaluated neurotransmitters and Vit D in pain pathway sensitization during the disease.     

PPD extract induces the maturation of human monocyte-derived dendritic cells

Dendritic cells (DCs) are the most powerful antigen presenting cells, capable of inducing T-dependent immune responses even in naive T cells. DCs are of special interest as cellular adjuvants for immunity induction in clinical settings and several methods for their generation and maturation are recently under investigation. The present study was set out to define the effects of PPD (Purified Protein Derivative), a mycobacterial extract used in the tuberculin skin test, on in vitro differentiation and maturation of human monocyte derived dendritic cells. Immature DCs were prepared from the peripheral blood monocytes of healthy volunteers by culturing in a medium supplemented with granulocyte macrophage colony stimulating factor (GM-CSF) and interleukin-4 (IL-4). The resultant cells were then stimulated with PPD extract and their properties such as cell morphology and the expression of key surface molecules were compared with tumor necrosis factor-alpha (TNF-alpha) stimulated immature DCs. Our results suggest that mycobacterial purified extract is as potent as TNF-alpha, a well-established DC stimulator, in induction of maturation in human monocyte derived DCs. We also ruled out the contribution of lipopolysaccharide (LPS) and beta-glucan contamination in maturation effect of PPD preparations. So, PPD as an examined safe material for in vivo consumption could be used to stimulate DC maturation in DC based immunotherapy protocols.     

Prognostic implications of calculated Apo‐lipoprotein B in patients with ST‐segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: Outcome is tied to lower cut‐points

BackgroundDebates still surround using lipoproteins including Apo‐B in risk assessment, management, and prognosis of patients with coronary artery disease. During an acute ST‐segment elevation myocardial infarction, Apo‐B might help to achieve incremental prognostic information.ObjectiveWe sought to determine the potential prognostic utility of calculated Apo‐B in a cohort of patients with STEMI undergoing primary PCI.MethodsA retrospective cohort study was conducted enrolling 2,259 patients with a diagnosis of acute STEMI who underwent primary PCI. Apo‐B was obtained using a valid equation based on initial lipid measurements. High Apo‐B was defined as a level of 65 or higher. Primary endpoint of the study was major adverse cardiovascular events (MACE).ResultsMean age of the participants was 59.54 years and 77.9% of them were male. After a Median follow up of 15 (6.2) months, high Apo‐B was associated with MACE and the OR (95% CI) was 3.02 (1.07–8.47), p = .036. Odds ratios for prediction of MACE pertaining to LVEF, and smoking were 0.97 (p = .044), and 1.07 (p = .033), respectively. However, High Apo‐B was not able to predict suboptimal TIMI flow. Accordingly, the Odds ratio was 0.56 (0.17–1.87), p = 0.349. The power of High LDL‐C and Non‐HDLC for prediction of MACE were assessed in distinct models. Attained odds ratios were [2.40 (0.90–6.36), p = .077] and [1.80 (0.75–4.35), p = 0.191], respectively.ConclusionCalculated Apo‐B appears to be a simple tool applicable for prediction of cardiovascular events in patients with STEMI superior to both Non‐HDLC and LDL‐C.     

Metabolic syndrome and menopause: A population-based study

BackgroundMetabolic syndrome has a key role in developing cardiovascular diseases. It has become a major problem in many countries, especially in women. This study was performed to evaluate the metabolic syndrome status and its changes through menopause.MethodsThe 25–64-year-old individuals in Population Lab of Tehran Medical University were studied through a single-stage cluster sampling. The study was designed according to the World Health Organization (WHO) Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) project using the Adult Treatment Panel III (ATP III) criteria. The study population consisted of 607 men and 966 women. The parameters used for the risk analysis were waist circumference, fasting serum triglycerides, high-density lipoprotein-cholesterol, blood pressure and fasting plasma glucose.ResultsThe prevalence was high in women especially after menopause. In post-menopausal women, prevalence exceeded that in men by more than twice (60.0% vs. 19.0%, p < 0.0001). The mean levels of metabolic syndrome-related risk factors were significantly higher in post-menopausal women. Even irregular menses was associated with significantly higher rate of hypertriglyceridemia (p = 0.011) and abdominal obesity (p = 0.044).ConclusionAlthough, previous studies have shown that women are protected against cardiovascular disorders, some factors have changed this pattern. So that prevalence of metabolic syndrome in women is now even higher than in men. This process exacerbates with the decrease in estrogen levels through menopause. Consideration of early prevention and therapy in this specific group is of great importance.     

Prospective evaluation of technetium-99m ECD SPET in mild traumatic brain injury for the prediction of sustained neuropsychological sequels

Our aim was to evaluate whether single photon emission tomography (SPET) versus computed tomography (CT) in acute phase of mild traumatic brain injury (MTBI) was better for the prediction of sustained neuropsychological symptoms beyond a typical recovery period. Forty five patients with MTBI were prospectively evaluated with clinical and neuropsychological exams, structural imaging using CT and perfusion study by(99m)Tc-ethylene cysteinate dimer ((99m)Tc-ECD) SPET within a week of the head trauma. After an interval ranging from 6 to 12 (median: 9) months, all patients were re-evaluated by standard neuropsychological tests for the assessment of sustained personality changes, imbalance and memory deficits. Our results showed that, 25 patients had abnormal brain perfusion on (99m)Tc-ECD SPET. In 19 cases of total 20 normal (99m)Tc-ECD SPET studies, no sign of memory deficit and imbalance was observed. Negative predictive value (NPV) for both complications was 95%. NPV of CT for the prediction of memory deficit and imbalance were 77.4% and 90.3%, respectively. The risk of developing sustained memory deficits and imbalance in patients with positive (99m)Tc-ECD SPET were 40% and 20%, respectively. A perfusion abnormality on (99m)Tc-ECD SPET was associated with a greater chance of long-standing memory deficits (odds ratio=13.49, P=0.020)while neither CT nor (99m)Tc-ECD SPET could independently predict the personality changes in these patients. The patients with abnormalities on both CT and SPET images faced a significant relative risk of complications, 1.63 times, higher than the others. In conclusion, our study indicated that (99m)Tc-ECD SPET imaging or CT imaging alone, could not predict the occurrence of sustained complications after MTBI. Concurrent use of both imaging modalities performed shortly after MTBI may yield the best results, as the combination of abnormalities in both cerebral structure and perfusion could indicate the patients with 1.63 times higher risk of sustained memory deficits, personality changes and imbalance.