Environmental exposure to natural sour gas containing sulfur compounds results in elevated depression and hopelessness scores

Some parts of Masjid-i-Sulaiman (MIS) (Khozestan provinces, southwest of Iran) are contaminated with subsurface leakage of natural sour gas containing H(2)S. It is reported that the incidence of suicide by self-burning in MIS is very high. High endogenous H2S levels have been found in the brain and it is involved in the brain functions. Because there is no report about the effect(s) of natural sour gas containing sulfur compounds on the function(s) of human brain, the present study was done. The study was performed on 128 individuals exposed or unexposed to natural sour gas. The exposed group consisted of 64 persons (39 males, 25 females). Unexposed subjects were matched by sex, age, and educational levels. Depression and hopelessness were determined using Beck's depression inventory (BDI) and Beck's hopelessness (BHS) questionnaires. Using multiple linear regression models, the averages of BDI (t=2.637, P=0.009) and BHS (t=3.344, P=0.001) were significantly higher among the exposed subjects than among the control group. In Lali 57.8% and 14.1% of subjects had no depressed mood and moderate to severe depressed mood, respectively, while in MIS 31.3% and 35.9% of subjects had no depressed mood and moderate to severe depressed mood, respectively; the difference was significant (chi2=12.88, df=3, P=0.005). In Lali 35.9% and 12.5% of subjects had no hopelessness at all and moderate to severe hopelessness, respectively, while in MIS 17.2% and 32.8% of subjects had no hopelessness at all and moderate to severe hopelessness, respectively, the difference was significant (chi2=11.49, df=3, P=0.009). Replication is necessary and health implications are discussed.     

Occupational sunlight exposure, polymorphism of glutathione S-transferase M1, and senile cataract risk

Background

The pathogenesis of cataract is influenced by a number of factors including oxidative stress. Glutathione S‐transferase (GST) catalyses the nucleophilic addition of the thiol of GST to electrophilic acceptors. It is important for detoxification of xenobiotics in order to protect tissues from oxidative damage.

Objectives

To examine whether the interaction of polymorphism of GSTM1 gene and occupational sunlight exposure modulate the risk of cataract.

Methods

Blood samples from 95 subjects with cataract and 95 age and sex matched healthy persons were collected. The genotypes of GSTM1 were determined using PCR.

Results

The null genotype of GSTM1 was associated with an increase in cataract risk in the indoor workplace, but this association was not significant in the outdoor subjects.

Conclusion

The active genotype of GSTM1 has lost its protective role in persons who work outdoors. It is suggested that activity of the GSTμ enzyme may be inhibited in the human lens after occupational exposure to UV light.     

Assessment of mechanism, type and severity of injury in multiple trauma patients: A cross sectional study of a trauma center in Iran

Purpose: To accurately assess the mechanism, type and severity of injury in Iranian multiple trauma patients of a trauma center. Methods: Patients with multiple traumas referring to the emergency department of Hasheminejad University Hospital in Mashhad, Iran, entered this cross sectional study from March 2013 to December 2013. All the patients with injury severity score (ISS) > 9 were included in this study. Data analysis was performed by SPSS software (Version 11.5) and P values less than 0.05 were considered as significant differences. Results: Among the 6306 hospitalized trauma patients during this period, 148 had ISS>9. The male female ratio was 80%. The mean age of the patients was (33.5 ± 19.3) years. And 71% of the patients were younger than 44 years old. There were 19 (13%) deaths from which 68.5% were older than 44 years old. The mean transfer time from the injury scene to hospital was (55 ± 26) minutes. The most frequent mechanisms of injury were motorcycle crashes and falling from height, which together included 66.2% of all the injuries. A total of 84% of hospital deaths occurred after the first 24 h of hospitalization. Head and neck were the most common body injured areas with a prevalence of 111 cases (75%). Conclusion: Motorcycle crashes have high frequency in Iran. Since most victims are young males, injury prevention strategies should be considered to reduce the burden of injuries.     

Assignment of the gene encoding type 1γ protein phosphatase catalytic subunit (PPP1CC) on human,rat, and mouse chromosomes

Summary Using fluorescentin situ hybridization (FISH) method, a gene encoding the catalytic subunit of protein phosphatase type 1 (PPP1CC) was mapped to human 12q24.1-q24.2, rat 7q22, and mouse 10C. These results indicate that thePPP1CC is a member of conserved synteny group between rat chromosome 7, mouse chromosome 10 and human chromosome 12. These data and mapping data about other members of PP1 family show that in spite of the high identity of PP1 isoforms, each isoform is encoded by different genes which located on different chromosomes in human, rat, and mouse.     

Should Oral Contrast Be Omitted in Patients with Suspected Appendicitis?

Background

Acute appendicitis is one of the most common surgical emergencies. Our study evaluated patients given the diagnosis of appendicitis and reviewed their workup and clinical outcomes. We specifically focused on the use of oral contrast followed by appendectomy.

Methods

We retrospectively reviewed all adult patients given an ICD-9 code for appendicitis at Northwestern Memorial Hospital between January 2000 and September 2010. Complication rates, time to the operating room, and length of hospital stay were compared between patients who received a CT scan and those who did not during the hospitalization for appendicitis.

Results

Average time from Emergency Department to the operating room was found to be statistically longer for patients who underwent a CT scan (10 h: 3, 1548) versus those who did not (6 h: 2, 262) (p?<?0.0001). There were 19 patients who had the complication of pneumonia and 4 patients who were diagnosed with acute respiratory distress syndrome postoperatively. Patients who underwent a CT scan and received oral contrast had a statistically higher number of both complications (p?<?0.0001).

Conclusions

The use of oral contrast is not necessary for an accurate diagnosis of appendicitis and may be associated with higher complication rates, longer hospital stays, and poor outcomes.

     

Twenty-Three-Hour-Stay Colectomy Without Increased Readmissions: An Analysis of 1905 Cases from the National Surgical Quality Improvement Program

Background

Isolated case series from highly specialized centers suggest the feasibility of a 23-h hospital stay after colectomy. We sought to determine preoperative variables associated with discharge within 23 h after colectomy to identify patients best suited for a short-stay model.

Methods

The American College of Surgeons NSQIP Colectomy-Targeted database was used to identify patients who underwent elective colectomy from 2012 to 2017. All cases with missing length of stay or inpatient death were excluded. Patients with a postoperative hospital stay ≤1 day were identified. Univariate and multivariate analyses were conducted to identify factors associated with early discharge.

Results

A total of 1905 patients were discharged within 23 h after surgery (1.6%). These patients were noted to be younger (59 versus 61 years, p < 0.001) and less likely to have insulin-dependent diabetes (3.0 versus 4.4%, p < 0.001), preoperative dyspnea (2.2 versus 6.0%, p < 0.001), COPD (3.0 versus 4.2%, p = 0.011), and hypertension (40.7 versus 46.9%, p < 0.001) than patients who stayed longer. Shorter operative time (OR 0.986, 95% CI 0.985–0.987, p < 0.001), minimally invasive techniques (OR 2.969, 95% CI 2.686–3.282, p < 0.001), lack of ostomy (OR 0.614, 95% CI 0.478–0.788, p < 0.001), and lack of ureteral stenting (OR 0.641, 95% CI 0.500–0.821, p < 0.001) were associated with early discharge in multivariable analysis. There was no increased incidence of readmission in patients discharged within 23 h.

Conclusions

Twenty-three-hour-stay colectomy is feasible on a national level and does not result in an increased incidence of readmission. Patients undergoing elective procedures without significant medical comorbidities may be eligible for early discharge. Preoperative factors may be used to select patients best suited for this short-stay model.