Evaluation of the Incidence of Chronic Thromboembolic Pulmonary Hypertension 1 Year After First Episode of Acute Pulmonary Embolism: A Cohort Study

Purpose

Chronic thromboembolic pulmonary hypertension (CTEPH) is an important complication after acute pulmonary embolism (PE) with considerable morbidity and mortality. The aim of this study was to estimate the CTEPH incidence in a cohort after the first occurrence of PE.

Methods

We conducted a 1-year follow-up cohort study between 2015 and 2018 to assess the incidence of CTEPH in 474 patients with their first acute episode of PE. For the diagnosis of CTEPH, patients with unexplained persistent dyspnea during follow-up underwent transthoracic echocardiography, right heart catheterization, ventilation-perfusion lung scanning, and CT pulmonary angiography.

Results

Overall, 317 patients were included in the study. The mean age of the patients was 56.5 ± 16 years. One hundred and three patients (32%) had exertional dyspnea at the 1-year follow-up. Patients with evidence of pulmonary hypertension (PH) on echocardiography underwent right heart catheterization. Eleven patients (18%) had no PH (mPAP < 25 mmHg); 47 patients (81%) had mPAP > 25 mmHg. Fifteen patients had PAWP > 15 mmHg, including those with underlying left heart problems or valvular diseases. There were 32 patients with PAH (mPAP > 25 mmHg and PVR > 3 WU) undergoing CTEPH studies; 22 patients (6.9%) had multiple segmental defects suggesting CTEPH on a perfusion scan.

Conclusion

The incidence of CTEPH observed in this study 1 year after the first episode of acute PE was approximately 6.9%. This incidence seems to be high in our population, and diagnostic and therapeutic strategies for the early identification of CTEPH are needed.

     

The status of blood safety in ECO member states

Background

Access to the information concerning blood safety is essential for managing problems and overcoming the challenges that are faced in any given region. Information on the availability and safety of blood in countries of the Economic Cooperation Organisation (ECO) is largely lacking. To address this problem, the Iranian Blood Transfusion Organisation, in collaboration with other ECO member states, initiated a research project in 2009 to collect, analyse and compare statistics on blood safety in the region.

Materials and methods

A modified and summarised version of the Global Database on Blood Safety (GDBS) questionnaire was used to collect data. The questionnaire was sent to all ten countries in the ECO region. The heads of the national transfusion services or focal points were requested to complete the form. Related literature and websites were also reviewed.

Results

Only three countries (Afghanistan, Iran and Turkey) completed the questionnaire, while other countries provided their available data on some parts of the questionnaire. The number of donations per year varied from 5 to 27/1,000 population. The rate of donors positive for human immunodeficiency virus ranged from 0.003% to 0.2%. The rate of donors positive for hepatitis C virus antibody varied from 0.05% to 3.9% while that of hepatitis B virus surface antigen ranged from 0.15% to 3.91% respectively.

Discussion

There is very clear diversity in blood transfusion services among ECO member states. Most countries in the region do not have a data-recording system. It is generally estimated that the need for blood is much higher than the supply in this region. Deficiencies in donor screening and a high prevalence of transfusion-transmitted infections are other important challenges.     

Amelioration of cardio-respiratory perturbations following Mesobuthus eupeus envenomation in anesthetized rabbits with commercial polyvalent F(ab′)2 antivenom

Immunotherapy is the only specific treatment for scorpion sting. In the present study, protective effects of polyvalent antivenom against hemodynamic disturbances, biomarkers (troponin T, creatinine kinase isoenzyme MB, Lactate dehydrogenase) changes, electrocardiogram abnormalities and histopathological complications in heart and lung induced by Mesobuthus eupeus scorpion venom was investigated in anesthetized rabbits. Twenty four rabbits were randomized into four equal groups: six rabbits in control group received 1 ml ultra-pure water subcutaneously (group 1). Group two received LD50 of venom (4.5 mg/kg). In the third and fourth groups, 5 ml of scorpion antivenom was administrated intravenously simultaneous with venom injection and 60 min following envenomation, respectively. Results of the present study indicate significant decrease in hemodynamic parameters following envenomation in the second group of animals. Venom injection caused edema, myocytolysis, coagulation necrosis, hemorrhage in heart as well as edema, hemorrhage and vascular thrombus in lungs. Although envenomed rabbits presented rises in LDH and TnT but no alteration in CK-MB was observed. Electrocardiogram monitoring of rabbits showed ST elevation and inverted T waves. Simultaneous administration of antivenom and venom prevented entirely the clinical signs, hemodynamic disturbances, markers changes, ECG abnormalities and histopathological damages. Delayed immunotherapy gradually ameliorated clinical signs, hemodynamic disturbances and markers changes related to envenomation. Histopathological evaluation showed slight alterations such as mild myocytolysis in heart and mild edema in lung following delayed immunotherapy. In conclusion, scorpion antivenom administration has preventive, neutralizing and curative properties for M. eupeus scorpion envenomation, if it would be applied at optimum time, dose and route.     

Synthesis and characterization of a novel magnetic porous carbon coated with poly(p-phenylenediamine) and its application for furfural preconcentration and determination in baby food and dry milk powder samples

The aim of the current research is to develop a MSPE method for the determination of furfural in baby food and dry milk samples. In this regard, a novel magnetic porous carbon composite coated with poly(p-phenylenediamine) was fabricated, characterized, and then applied to the preconcentration/extraction of furfurals from baby food and dry milk powder samples. Initially, magnetic nanoparticles (Fe₃O₄) were synthesized, and then coated with a metal–organic framework layer named MIL-101(Fe). Afterward, the magnetic MIL-101(Fe) was subjected to calcination under a nitrogen atmosphere and magnetic porous carbon was achieved. Finally, a layer of poly(p-phenylenediamine) was coated on the magnetic porous carbon. The structure of the nanocomposite was investigated with various methods, including FT-IR spectroscopy, electron microcopies (SEM and TEM), VSM, and XRD. The fabricated nanocomposite was applied in magnetic solid-phase extraction of furfural and hydroxymethyl furfural and their determination with liquid chromatography. The effect of experimental variables was explored by using an experimental design approach. The LODs and linear range for the target furfurals were 1.0–2.0 μg kg⁻¹ and 3.0–500 μg kg⁻¹, respectively. The method''s repeatability was explored using RSD values and was found to be in the range of 5.2–6.4% (one-day, n = 5) and 9.1–10.8% (day to day, n = 3). Eventually, this new method was employed for the extraction/quantification of target compounds in baby food and dry milk powder samples.

In this research, a novel magnetic porous carbon composite coated with poly(p-phenylenediamine) was fabricated, characterized, and then applied to the preconcentration/extraction of furfurals from baby food and dry milk powder samples.     

Toxicity effects of AgZnO nanoparticles and rifampicin on Mycobacterium tuberculosis into the macrophage

The World Health Organization acknowledges tuberculosis as a global threat. Tuberculosis infection is one of the top 10 causes of death worldwide. Nanotechnology and microbiology researchers are looking for new and safe nano drugs for eliminating Mycobacterium tuberculosis, the causative agent of tuberculosis. In this study, AgZnO nano‐crystals (AgZnONCs) is synthesized via the decomposition of the precursor of oxalate method. Characterization of AgZnONCs were evaluated. Next, various concentrations of AgZnONCs, as well AgZnONCs+Rifampicin, were prepared. The MTT assay was employed to study the viability of human macrophage cell lines (THP‐1) exposed to AgZnONCs. The bactericidal effects of AgZnONCs and AgZnONCs+Rifampicin were studied by Minimum Bactericidal Concentration (MBC) test. Subsequently, THP‐1 were infected by H₃₇Rv strain of M. tuberculosis (H₃₇RvMtb). Also, bactericidal effects of AgZnONCs and AgZnONCs+Rifampicin were compared with ex‐vivo conditions. The MBC of AgZnONCs and AgZnONCs+Rifampicin were ratios of 1:4 and 1:32 respectively (p‐value <0.05). Also, more than 50% and 80% of THP‐1 were alive in ratios of 1:4 and 1:32 in the presence of AgZnONCs, respectively. All phagocytic H₃₇RvMtb were killed in the presence of AgZnONCs+Rifampicin (p‐value <0.05), while AgZnONCs were not able to kill all the H₃₇RvMtb (p‐value >0.05). This study showed that, AgZnONCs+Rifampicin has the most anti‐tubercular behavior with respect to the macrophages.     

Efficacy of Cisplatin-loaded polybutyl cyanoacrylate nanoparticles on the glioblastoma

Glioblastoma is known as one of the most aggressive human cancers. To gain access of the brain, therapeutic agents must overcome blood–brain barrier (BBB). In this study, Cisplatin (Cispt)-loaded polybutylcyanoacrylate (PBCA) nanoparticles (NPs) were prepared through miniemulsion polymerization technique. They were coated with polysorbate 80 to cross the BBB of glioblastoma-bearing rats. Prepared NPs were characterized with respect to their size, size distribution, zeta potential, drug loading and encapsulation efficiency, cytotoxicity effects, drug release, and stability pattern. Size and zeta potential of nanodrug were found to be 489 nm and ?20 mV, while drug loading and encapsulation efficiency were determined to be 5 % and 25 %, respectively. Release studies demonstrated high retention capability of nanodrug in that 3.18 % of Cispt was released from NPs in a period of 51 h. NPs presented acceptable stability after 2 months and lyophilization. Mean survival time in nanodrug receivers was 19.6 days, while it was 17.5 days for free drug receivers. Histological studies demonstrated efficacy of PBCA NPs in reducing side effects. Finally, such preparation can be considered as a promising nanocarrier for other types of tumor.     

Effects of dermal exposure to chlorpyrifos on liver and brain structures and biochemical parameters in rabbits

Chlorpyrifos, an organophosphate insecticide, inhibits the enzyme acetylcholinesterse resulting in the accumulation of acetylcholine at the nerve endings. In the present research chlorpyrifos was administered via dermal contact to New Zealand white rabbits to determine its effects on biochemical indices on the rabbits as well as the pathological changes in their liver and brain. Twelve adult male rabbits were randomly assigned to two equal groups (N?=?6; treatment and control group). The treatment group received chlorpyrifos via dermal contact at the doses of 50?mg per kilogram body weight everyday during the first week. The daily doses for the second, third, and fourth weeks were 100, 250, and 400?mg/kg body weight, respectively. The control group received ethyl alcohol as the solvent of chlorpyrifos during the same period. Blood samples from marginal ear vein of both groups were collected on days?0, 7, 14, 21, and 28. Statistical study revealed that chlorpyrifos has harmful effects on the biochemical indices of the treated rabbits. These changes included significant increase in the level of ALP, AST, ALT, and cholesterol in the serum (p?<?0.05, p?<?0.01). Also significant decrease was observed in triglyceride and total protein level of the serum in the treatment group as compared with the control group (p?<?0.05). On day?28, the rabbits in both groups were euthanized. Histopathological changes including necrosis of hepatocytes, infiltration of lymphocyte cells, hyperemia, and proliferation of fibroblasts were observed in liver tissue of the exposed rabbits. In addition, necrosis of neuron, encephalitis (perivascular cuffing), hyperemia in blood vessels, gliosis, and necrosis of Purkinje cells in cerebellum were seen in the brain sections. The study confirmed that organophosphate intoxication from chlorpyrifos can occur via dermal exposure. Dermal contact to chlorpyrifos can have toxic effects on biochemical indices. It can also have pathologic effects on the liver and brain tissue.