Knowledge levels and attitudes of health care professionals toward patients with hepatitis C infection

AIM: To study knowledge levels and attitudes of health care providers toward patients with hepatitis C virus infection in Guilan, a northern province of Iran.METHODS: This cross-sectional study was performed on 239 health care professionals from the Razi Hospital, including doctors, nurses, and operating room technicians. The questionnaires consisted of questions on demographic characteristics, knowledge levels, and attitudes toward hepatitis C patients. The questionnaire was tested in a pilot study and validated by Cronbach’s alpha coefficient. Data were analyzed using SPSS16 software.RESULTS: The mean ± SD knowledge score was 17.43 ± 2.65 (from a total of 22). 51.9% of the participants achieved scores higher than the mean. There was a significant relationship between knowledge score and age (P = 0.001), gender (P = 0.0001), occupational history (P = 0.0001), and educational history (P = 0.027). There was also a significant relationship between attitude level and age (P = 0.002), gender (P = 0.0001), occupational history (P = 0.0001), and educational history (P = 0.035). Physicians were significantly more knowledgeable and showed more positive attitudes. There was a positive correlation between knowledge and attitude scores (P = 0.02).CONCLUSION: Discriminatory attitudes are common among health care providers toward hepatitis C patients. It is therefore necessary to improve their knowledge level and attitude toward this disease.     

Mussel inspired ZIF8 microcarriers: a new approach for large-scale production of stem cells

Metal–organic frameworks (MOFs) have high porosity, large surface area, and tunable functionality and have been widely used for drug loading. The aim of this study was to exploit unique features of zeolitic imidazolate framework-8 (ZIF8) to develop an innovative composite microcarrier (MC) for human mesenchymal stem cells (hMSCs) adhesion and proliferation. ZIF8 MCs were prepared by immobilization of polydopamine/polyethyleneimine (PDA/PEI) and ZIF8 on the surface of polystyrene beads. The chemical properties of MCs such as coating stability and homogeneity were characterized by different techniques such as ATR-FTIR, XRD, EDX, SEM, and contact angle. The prepared MCs were tested using human adipose-derived mesenchymal stem cells (hADSCs) in both static and dynamic conditions, and results were compared to a commercially available MC (Star-Plus), polydopamine coated MCs and amine-functionalized MCs as a control. Results show that PDA/PEI/ZIF8 coated MCs (in short: ZIF8 MCs) provides an excellent biocompatible environment for hADSCs adhesion and growth. In conclusion, ZIF8 MCs represent suitable and low-cost support for hADSCs culture and expansion, which can maximize cell yield and viability while preserving hADSCs multipotency. The present findings have revealed this strategy has the potential for chemical and topographical modification of MCs in tissue engineering applications.

Mussel inspired ZIF8 microcarriers with high surface area, biocompatibility, and nanoscale surface roughness are applied to enhance mesenchymal stem cell attachment and proliferation in 3D cell culture.     

Phenotypic detection of Klebsiella pneumoniae carbapenemase among burns patients: First report from Iran

Background

Resistance to antimicrobial agents such as carbapenems among enterobacteriacea has been increasing, especially in Klebsiella pneumonia that produces variety of enzymes including Klebsiella pneumoniae carbapenemase (KPC). This study is the first report of its kind investigating the resistance to carbapenems among burns patients in Iran.

Method

During a 6-month period, 28 hospitalized burn patients who required to be placed on broad spectrum antibiotics were studied. Isolated species identified by routine biochemical test. Susceptibility testing for these species was performed by recommended the CLSI guidelines method. The tested antibiotics included cefotaxime, cefepime, aztreonam, imipenem, amoxicillin + clavulonic acid, gentamicin, amikacin, tobramycin, tetracycline, and trimethoprim-sulfamethoxazole, and chloramphenicol. For determination of KPC in phenotypical forms, Modified Hodge Test was utilized as per CLSI recommendation.

Results

Thirty-five Klebsiella spp. were isolated from 28 hospitalized patients. Nineteen out of 35 Klebsiella isolates were resistant to imipenem and that all of them had positive KPC. Nine of imipenem resistant isolates were also resistant to all tested antibiotics. Mortality rate among patients with positive KPC was 33%.

Conclusion

High rate of multi-drug resistant (MDR) strains in isolates with positive KPC is a major challenge in Iran and that it could cause an increase in both mortality and morbidity among burn patients. Thus, appropriate infection control measures and guidelines are needed to prevent such infections among burn patients.     

Effect of opium dependency on secondary intention wound healing in a rat model: an experimental study

Opium dependency is a social and health problem in some middle eastern countries like Iran. Many of these people may require surgery. This study investigates the effects of opium dependency on histological parameters of secondary intention wound healing in rat. A full‐thickness wound (2 × 2 cm in diameters) was created on the dorsum of two groups of rats, a normal control group and a second group of rat depended to opium (Badawy's method). Several times during 14 days postwounding, the wound was excised with peripheral margins of normal skin and was evaluated for cellular population, reepithelialisation and revascularisation. Results are presented as the mean ± standard error. Data were compared by an unpaired t‐test or analysis of variance. Histological examination of the wound tissue showed evidence of increased population of fibroblasts, decreased recruitment of neutrophile and plateau of macrophage cells in opium depended animals comparing with control group. In the depended animals, reepithelialisation was seen to be enhanced significantly, while prohibiting progression of revascularisation. This study shows that opium dependency enhances reepitheliazation as well as tissue recruitment of fibroblasts; thereby probable enhancement of secondary intention wound healing.     

Dietary patterns and anthropometric indices among Iranian women with major depressive disorder

Major depression is a common mental disorder among women. A number of studies have demonstrated the association between some nutrients and food items with depression, but the studies on the association of dietary patterns with depression, especially in the Middle East, are rare. Further, the literature examining the relationship between anthropometric status and depression are inconsistent. In this study, 45 women with major depression and 90 patients with no mental disorder participated. We collected dietary intakes by a semi-quantitative food frequency questionnaire, and measured anthropometric indices (weight, height, waist and hip circumferences). Using factor analysis, two major dietary patterns were extracted: Healthy and Unhealthy. After adjusting for confounders, individuals who gained higher scores in healthy dietary pattern, had 84% lower odds of major depression; while the odds of major depression in participants who gained higher scores in unhealthy dietary pattern showed no significant association. No significant association was found between anthropometric indices and major depression. These results suggest that the healthy dietary pattern is significantly associated with lower odds of major depression in adult women. Further researches are needed to confirm these findings.     

Gemfibrozil Pretreatment Affecting Antioxidant Defense System and Inflammatory, but not Nrf-2 Signaling Pathways Resulted in Female Neuroprotection and Male Neurotoxicity in the Rat Models of Global Cerebral Ischemia–Reperfusion

Two important pathophysiological mechanisms involved during cerebral ischemia are oxidative stress and inflammation. In pathological conditions such as brain ischemia the ability of free radicals production is greater than that of elimination by endogenous antioxidative systems, so brain is highly injured due to oxidation and neuroinflammation. Fibrates as peroxisome proliferator-activated receptor (PPAR)-α ligands, are reported to have antioxidant and anti-inflammatory actions. In this study, gemfibrozil, a fibrate is investigated for its therapeutic potential against global cerebral ischemia–reperfusion (I/R) injury of male and female rats. This study particularly has focused on inflammatory and antioxidant signaling pathways, such as nuclear factor erythroid-related factor (Nrf)-2, as well as the activity of some endogenous antioxidant agents. It was found that pretreatment of animals with gemfibrozil prior to I/R resulted in a sexually dimorphic outcome. Within females it proved to be protective, modulating inflammatory factors and inducing antioxidant defense system including superoxide dismutase (SOD), catalase, as well as glutathione level. However, Nrf-2 signaling pathway was not affected. It also decreased malondialdehyde level as an index of lipid peroxidation. In contrast, gemfibrozil pretreatment was toxic to males, enhancing the expression of inflammatory factors such as tumor necrosis factor-α, nuclear factor-κB, and cyclooxygenase-2, and decreasing Nrf-2 expression and SOD activity, leading to hippocampal neurodegeneration. Considering that gemfibrozil is a commonly used anti-hyperlipidemic agent in clinic, undoubtedly more investigations are crucial to exactly unravel its sex-dependent neuroprotective/neurodegenerative potential.     

Simultaneous Inhibition of COX-2 and Activation of PPAR-γ Resulted in the Same Level and Pattern of Neuroprotection as They were Targeted Separately

The inflammatory response is an immune response of the body when exposed to internal and external stimuli. Cyclooxygenases (COX) are major inflammatory mediators implicated in inflammation. COX-2 is reported to be involved in neuroinflammation. Moreover, 15-Deoxy-d ^12,14-prostaglandin J2 (15d-PGJ2), an endogenous ligand of peroxisome proliferator-activated receptor gamma (PPAR-γ), has been demonstrated to have anti-inflammatory actions. In this study, we investigated whether co-therapy of a selective COX-2 inhibitor NS-398 and 15d-PGJ2 as a PPAR-γ ligand could exert additional neuroprotective effects in rat pheochromocytoma (PC12) cells. Our findings showed that 15d-PGJ2 and NS-398 suppress the apoptotic pathway in PC12 cells exposed to H₂O₂ by attenuation of the Bax/Bcl-2 ratio. This effect was mediated through PPAR-γ, as it was reversed by GW9662 (a PPAR-γ inhibitor). Also, 15d-PGJ2 and NS-398 induced the Nrf2 signaling pathway and decreased NF-κB level in a PPAR-γ-dependent manner. We found that coadministration of a selective COX-2 inhibitor and a PPAR-γ ligand in PC12 cells has equal neuroprotective effect compared to their effects when used separately. Considering the higher affinity of 15d-PGJ2 for PPAR-γ than NS-398, it seems that the observed neuroprotection of this combination therapy was from 15d-PGJ2.     

Reversal of Prenatal Morphine Exposure-Induced Memory Deficit in Male But Not Female Rats

Impaired memory performance in offspring is one of the long-lasting neurobehavioral consequences of prenatal opiate exposure. Here, we studied the effects of prenatal morphine exposure on inhibitory avoidance memory performance in male and female offspring and also investigated whether these deficits are reversible during the postnatal development. Pregnant Wistar rats received morphine sulfate through drinking water, from the first day of gestation up to the day 13, M_1–13, or to the time of delivery, M_1–21. Four- and ten-week-old (adolescent and adult, respectively) male and female offspring were subjected to behavioral assays and then analysis of proteins involved in apoptosis or in synaptic plasticity. Results revealed that adolescent and adult female rats failed in passive avoidance retention task in both M_1–13 and M_1–21 groups. Adolescent and adult male offspring were similar to control animals in M_1–13 group. However M_1–21 impaired retention task in prepubertal male offspring, and this memory loss was repaired in postpubertal stage. Consistently, Bax/Bcl-2 ratio and cleaved caspase-3 were significantly increased in both M_1–13 and M_1–21 adolescent and adult female rats, but only in M_1–21 adolescent male rats. Furthermore, prenatal morphine exposure reduced the expression of brain-derived neurotrophic factor precursor protein in adolescent and adult female offspring and also decreased p-ca(2+)/calmodulin-dependent kinase II/ca(2+)/calmodulin-dependent kinase II ratio in adolescent male and female rats. Altogether, the results show that prenatal morphine exposure, depending on the time or duration of exposure, has distinct effects on male and female rats, and postnatal development may reverse these deficits more likely in males.     

Rational design of yolk–shell nanostructures for drug delivery

Yolk–shell nanoparticles (YSNPs) are a new class of hollow nanostructures, and their unique properties can be utilized in drug delivery systems. The recent progress in YSNPs-based carriers is highlighted in drug delivery systems. Doxorubicin hydrochloride, ceftriaxone sodium, and methotrexate are three of the most common drugs that are used in this field. According to the reported studies, the materials used most often as yolk–shells are magnetic nanoparticles and polymers. The used methods for synthesizing a diverse array of YSNPs are classified based on their core structures. Various properties of YSNPs include their high drug-loading capacity, and their ability to decrease drug toxicity and satisfactorily and efficiently release drugs.

The recent progress in yolk–shell nanoparticles (YSNPs) as a new class of hollow nanostructures applied for drug delivery.