چکیده مقاله

 Heart failure is one of the serious cardiovascular diseases, which poses a global pandemic and places a heavy burden on health care systems worldwide. The incidence of this disease in Iran is higher than in other Asian countries. To reduce patients' complications, readmission rates, and health care expenditures, it is necessary to design interventions, which are culturally appropriate and based on community needs. In 2016, a randomized clinical trial (IRCT2017010731804N1) was initiated to compare tailored tele-monitoring intervention with usual care. In total, 80 patients completed the study after a follow-up period of 8 weeks. The primary end point was heart failure self-care, which was measured using the Iranian version of the European Heart Failure self-care questionnaire. Secondary end points were heart failure related readmission rates. The mean scores for self-care behaviors of the two groups showed significant difference at the baseline ( This study showed that tele-monitoring improved self-care behaviors in Iranian patients with heart failure but did not reduce their readmission rates.

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Drug resistance among gram-negative bacteria is a worldwide challenge. Due to the importance of drug-resistant Klebsiella pneumoniae and Escherichia coli strains in hospital-acquired infections, we aimed to determine the phenotypic and genotypic characteristics of ESBLs, AmpC and Carbapenemase-producing isolates, obtained from hospitalized patients in Tehran and Ilam, Iran.In total, 90 isolates of K. pneumoniae and 65 E. coli isolates were collected from various infections. Phenotypic identification of bacterial isolates was performed, using standard methods. Phenotypic screening of ESBLs, AmpC and Carbapenemase enzymes were carried out. Detection of the genes of ESBL, AmpC and carbapenemase was also performed by the PCR method.Phenotypic detection tests showed that 36 (40%) K. pneumoniae and 23 (35.4%) E. coli isolates were ESBL producers. Moreover, 18 (20%) and 6 (9.2%) of K. pneumoniae and E. coli isolates were AmpC producers, respectively. Modified Hodge test results indicated that 39 (43.3%) K. pneumoniae and 18 (27.7%) E. coli isolates produced carbapenemase. Molecular tests showed that 40% of K. pneumoniae and 36.9% of E. coli isolates were ESBL-positive. AmpC was detected in 24.4% and 13.8% of K. pneumoniae and E. coli isolates. Carbapenemase was detected in 34 (37.8%) K. pneumoniae and 13 (20%) E. coli isolates.In this study, three K. pneumoniae isolates simultaneously carried ESBLs, AmpC and carbapenemase genes. Up to date strategies such as combination therapy or utilization of new antimicrobial agents might help combat such drug-resistant organisms.

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Worldwide, special attention has been paid to wild mushrooms-induced poisoning. This review article provides a report on the global pattern and characteristics of mushroom poisoning and identifies the magnitude of mortality induced by mushroom poisoning. In this work, reasons underlying mushrooms-induced poisoning, and contamination of edible mushrooms by heavy metals and radionuclides, are provided. Moreover, a perspective of factors affecting the clinical signs of such toxicities (e.g. consumed species, the amount of eaten mushroom, season, geographical location, method of preparation, and individual response to toxins) as well as mushroom toxins and approaches suggested to protect humans against mushroom poisoning, are presented.

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In recent years, there is a growing interest in new medical applications of botulinum toxin, including pain control, osteoarthritis treatment, and wound healing. While clinical applications of botulinum toxin seem promising, existing evidence regarding the therapeutic effects is still inadequate. The aim was to assess the efficacy of a single injection of abobotulinumtoxin A into the knee joint cavity to reduce pain in elderly people. We carried out a single group clinical trial in a University Hospital. Thirty participants (24 women) more than 50 years of age with knee osteoarthritis were included. Diagnosis of osteoarthritis was based on clinical and radiologic findings. We gave a single injection containing 250 units of Dysport (= 100 units of botulinum neurotoxin type A) diluted with 5 ml of normal saline. The primary outcome measure was knee pain. The secondary outcome was the patients' opinion about their knee and associated problems measured with the Knee injury and Osteoarthritis Outcome Score. The outcomes were measured at the baseline and at 4 weeks after the intervention. Within-group comparisons based on the Knee injury and Osteoarthritis Outcome Scores showed favorable results for joint pain and stiffness, sports, severity of symptoms, quality of life, and daily activities (all p-values < 0.001). Also, pain intensity, joint effusion, knee clicking and locking, and flexion-extension scores showed significant beneficial results (all p-values ≤ 0.005). We concluded that botulinum neurotoxin type A is an effective and safe initial treatment of knee osteoarthritis with clear clinical advantages. Patients' satisfaction, minimum adverse effects in addition to single-dose prescription make the toxin as a choice for the first-line therapy of osteoarthritis at least at the short-term in elderly people. The symptom relief increases the patient's compliance and willing to participate in other therapeutic programs. REGISTRATION: Iranian Registry of Clinical Trials (IRCT) website http://www.irct.ir/, a WHO Primary Register setup, with registration code: Irct ID: IRCT20180416039323N1.

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An experiment was conducted to study the effect of water supplementation of organic acid-chelated trace minerals (OTM) on production traits, carcass characteristics, intestinal histomorphology, and nutrient digestibility in African ostrich chicks from 8 to 12 mo of age. A total of 20 growing ostriches, with almost similar body weight (73.4 to 75.8 kg), were individually distributed in outdoor paddocks of ≈ 24 m2 and were randomly allocated into 1 of the following 4 treatments: (1) control/basal diet, (2) low OTM (basal diet + 100 mg/bird/day OTM powder in water), (3) medium OTM (basal diet + 1 g/bird/day OTM powder in water), and (4) high OTM (basal diet + 2 g/bird/day OTM powder in water). The body weight gain and feed conversion efficiency were greater (P < 0.05) in ostriches receiving medium-OTM treatment compared to control during the overall phase of the experiment. Although whole carcass yield, the yield of parts, and the relative weights of internal organs were not affected by experimental treatments, supplementation of higher amounts of OTM (medium- and high-OTM) resulted in a decrease (P < 0.05) in the subcutaneous and abdominal fat contents. Medium- and high-OTM treatments increased (P < 0.05) the villus height/crypt depth ratio in the jejunum and ileum compared with control and low-OTM treatments. Moreover, ostriches receiving the medium-OTM had also higher total tract apparent digestibility of energy (P = 0.048), ether extract (P = 0.050), crude fiber (P = 0.063), and higher AMEn (P = 0.094) than the control group. Overall, supplementation of OTM at the level of 1 g/bird/day to the drinking water of growing ostriches fed diets containing the recommended levels of inorganic trace minerals could beneficially affect productive performance, nutrient digestibility, and intestinal morphology.

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Background The most common high-risk behaviors that have profound and adverse effects on the health of the community take place in the university environment. Nowadays, the necessity of exploring ways to correct and reduce the high-risk behaviors requires identification of its determinant factors. Therefore, the present study aimed to investigate the correlation between spiritual health and high-risk behaviors among university students in the southeast of Iran in 2017-2018. Method This survey was a cross-sectional study. The population was all students studying at three central Universities in Kerman. Eight hundred and four students participated in the survey using a quota sampling method. The research instrument was a demographic questionnaire and the 20-item spiritual well-being Palutzian and Ellison scale and the Iranian Adolescent Riskiness Scale (IARS), which includes 39 items for high-risk behaviors. Results The mean total score of high-risk behaviors was 79.16 ± 24.6 which was lower than the median (117). The spiritual health of the majority of subjects (66.7%) was moderate with an average of 90.65 ± 16.64. There was a significant negative correlation between the students' spiritual health and their high-risk behaviors. Conclusion It is necessary and essential to plan and implement spiritual-based interventions to reduce the incidence of high-risk behaviors.

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Neuromyelitis optica (NMO), also known as Devic's disease, is an autoimmune disorder of the central nervous system (CNS) in which immune system cells and antibodies primarily attack the optic nerves and the spinal cord. OX40 (CD134) is a tumor necrosis factor (TNF)-receptor family member expressed primarily on activated CD4+ and CD8+ T-cells. In an autoimmune disease, OX40 is typically up-regulated at sites of inflammation, and increases in the number of peripheral CD4+ T-cells expressing OX40. OX40 and its ligand OX40L are key TNF members that augment T-cell expansion, cytokine production, and promote T-cell survival. The aim of this study was to evaluate and compare of OX40 gene expression and its serum levels in patients with NMO and healthy controls. Twenty sex-/age-matched healthy controls (HC) (median age = 32 years, 15 females/5 males) were engaged for the present study. Expression of OX40 at the transcript level and serum protein levels were measured by quantitative real-time polymerase chain reaction (qRT-PCR) and enzyme-linked immunosorbent assays, respectively. The results indicated OX40 expression in patients was significantly lower than in healthy controls (p = 0.001). However, the serum level of OX40 was not significantly different between groups (p = 0.37). In addition, the results indicated that CD134 expression was not age-related (p = 0.041). Overall, this study suggests to us that OX40 levels are not a suitable marker for diagnosis or treatment of NMO.

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This meta-analysis was designed to review the published reports regarding the concentration and/or prevalence of aflatoxin M

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This study describes the isolation of a leech following the presentation of unusual vaginal bleeding. Vaginal bleeding in children due to a leech bite is very rare. This is the first report of severe bleeding in a virgin 14-year-old girl from Mashhad, Iran due to the presence of a leech in the vagina.

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چکیده مقاله

The promising non-clinical antileishmanial effects of gentian violet (GV) encouraged us to evaluate the additive effect of GV on cryotherapy.For 8 weeks, 59/161 cutaneous leishmaniasis patients/lesions underwent cryotherapy alone (group 1) or cryotherapy accompanied by 1% GV application (group 2). The primary endpoint was clinical response.Ultimately, 54.7% and 45.3% of the significantly cured lesions belonged to groups 1 and 2, respectively, which was not statistically significant. The clinical response was significantly different between the two groups at the end of the fourth week.Although the clinical response of the two groups was significantly different at the end of the fourth week, application of GV did not increase the efficacy of cryotherapy.

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Long-term psychodynamic psychotherapy (LTPP) emphasizes the centrality of intrapsychic and unconscious conflicts and their relation to development. Although there is evidence supporting the efficacy of LTPP in mental disorders, little research has been published on the efficacy of LTPP for depressive and anxiety disorders.To examine whether patients with anxiety and depressive disorders demonstrate improvement in their attachment styles, defense styles, psychiatric symptoms, anxiety/depressive symptoms, and alexithymia with LTPP.In this retrospective, descriptive study, the psychological outcomes of patients who were treated at the psychoanalytic clinic of Babol University of Medical Sciences were assessed. Fourteen patients diagnosed with depressive or anxiety disorder participated in the study of LTPP using the self-psychology approach. The Beck Depression Inventory II, Beck Anxiety Inventory, Adult Attachment Scale, 40-item Defense Style Questionnaire, and the 20-item Toronto Alexithymia Scale were administered at pre-treatment, post-treatment, and 6-month follow-up. Generalized estimating equations were used to analyze changes in psychological outcomes after each of the three assessments.The mean scores of depression and anxiety and secure attachment improved significantly after LTPP with self-psychology approach from baseline to post-treatment and follow-up. Also, the mean scores of neurotic and immature defenses, difficulty in identifying feelings, difficulty in describing feelings, externally oriented thinking, and total alexithymia scores decreased significantly from baseline to post-treatment and follow-up.Symptoms of anxiety disorders, depressive disorders, insecure attachment styles, alexithymia, and neurotic/immature defense styles improved after the LTPP with self-psychology approach. Moreover, the improvements persisted at the 6-month follow-up.

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چکیده مقاله

Increased levels of iron in body are attributed to higher cancer risk. Given the fact that 16% of all human cancers are caused by viral infections, iron is suggested to play an important role in carcinogenesis particularly those induced by viral infections. The present study provides an updated summary of the literature and the plausible mechanisms of iron involvement in cancer development by viruses. Our understanding about the interplay between viral infections and iron in different settings particularly cancer development is yet to be improved as it may shed a new light in development of new therapeutic strategies.

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An efficient diastereoselective synthesis of spirocyclopropaneoxindoles is reported using three-component reactions of various phenacylidenetriphenylphosphorane, isatins and phenacylbromide under ultrasonic irradiation. The structures of synthesized spirocyclopropaneoxindoles were characterized by their spectral data. The antioxidant activities of the synthesized compounds were evaluated by 1,1-diphenyl-2-picrylhydrazyl radical scavenging assay. Among the products those with NH group in their structure exhibited higher antioxidant activities than other derivatives. Also, In vitro cytotoxicity of compounds 4b,e,j,k were examined against HeLa cancer cell lines using MTT assay. The results revealed that compound 4j with chlorine substituent on phenyl group displayed higher cytotoxicity activity (IC50 = 4.50 ± 0.30 μg/mL) after 48 h.

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We investigated the role of stattic as an adjuvant molecule to increase the cytotoxicity of 5-fluorouracil (5-FU) through specific inhibition of molecular targets, signal transducer and activator of transcription 3 (STAT3) and nuclear factor erythroid 2-related factor 2 (Nrf2) in HT-29 colon cancer cells. Cytotoxicity and apoptotic effects were investigated by methylthiazolyldiphenyl-​tetrazolium bromide assay and flow cytometry analysis, respectively. Real-time polymerase chain reaction was applied to assess the messenger RNA (mRNA) level of STAT3, Nrf2, and apoptotic genes including Bax, Bcl-xl, and Bcl-2. The antitumor effect of 5-FU in combination with stattic induced synergistic effect in HT-29 cells with combination indexes (CIs) 0.49. Flow cytometric results related to apoptotic confirmed that there was up to 40% increase in the population of apoptotic cells in HT-29 colon cancer cells incubated with 5-FU and stattic compared with control groups. Our data from gene expression determined a substantial diminish in the mRNA levels of the Nrf2 and antiapoptotic gene Bcl-2 along with a noticeable increase in the level of the proapoptotic Bax in HT-29 colon cells that underwent cotreatment with 5-FU and stattic (P < 0.05). Moreover, the results exhibited that stattic can be used as adjuvant chemotherapy besides the 5-FU. This therapeutic approach in colon cancer could mediate 5-FU chemoresistance via modulating therapeutic targets (ie, STAT3 and Nrf2 pathways) and decreased 5-FU-related adverse effects.

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Amyloid fibrils, including β-amyloid (Aβ) fibrils, are protein aggregates that form under certain conditions, associated with neurodegeneration that interfere with neural synaptic transmission resulting in some neural disorders, such as Alzheimer disease. The aim of this study is to inhibit amyloidogenesis by using preparatory polymeric nanomicelles as therapeutic agents and also as nano carriers for curcumin to target Aβ fibrils through the glycation method of Bovine Serum Albumin (BSA) in the presence of Phosphate Buffer Saline (PBS). Polymeric nanomicelles were prepared from Phosphatidylethanolamine-distearoyl methoxypolyethylene glycol conjugates in the presence and absence of Curcumin and then the morphological and structural characteristics of the nanomicelles were characterized in detail. Following the preparation of unloaded and curcumin-loaded nanomicelles with the desired size and properties, their effects on BSA glycation/fibrillation process were investigated. The samples were analyzed by Thioflavin T (ThT) fluorescence and Advanced Glycation End (AGE) products autofluorescence meaurements. The results showed that Thioflavin T fluorescence related to the formation of β-sheets and AGE autofluorescence (associated to AGE production) decreased in the presence of curcumin-loaded nanomicelles more than other samples. In conclusion, the promising effect of curcumin-loaded nanomicelles on inhibition of amyloidogenesis through glycation process due to curcumin release and thus their ability to prevent the formation and accumulation of amyloid fibrils and so to suppress the Alzheimer's disease progression has been proven and can go for further investigations. Curcumin can nullify free radicals' effect generated during the glycation process Curcumin-loaded nanomicelles can inhibit amyloidogenesis through glycation process The proposed systems can further develop to suppress Alzheimer's disease progression This article is protected by copyright. All rights reserved.

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Effect of alpha-linolenic acid (ALA) against ovalbumin (OVA)-induced inflammation, oxidant/antioxidant imbalance and pathological features was examined in rat.Total and differential WBC count and oxidant/antioxidant levels in BALF (bronchoalveolar lavage fluid) as well as lung pathological features were investigated in five groups of rats including controls (group C), rats sensitized with OVA (group S) and S treated with either ALA (0.2 and 0.4 mg/ml) or dexamethasone.As compared to group C, in OVA-sensitized rats, increases in WBC counts, levels of oxidant biomarkers and most pathological scores were observed while lymphocyte percentage and antioxidants levels decreased. Treatment with ALA (0.2 and 0.4 mg/ml) significantly reduced total WBC, NOAlpha-linolenic acid suppressed inflammation and oxidative stress, making it a potential therapeutic candidate for treatment of airway inflammatory diseases such as bronchial asthma.

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l-Asparaginases hydrolyzing plasma l-asparagine and l-glutamine has attracted tremendous attention in recent years owing to remarkable anticancer properties. This enzyme is efficiently used for acute lymphoblastic leukemia (ALL) and lymphosarcoma and emerged against ALL in children, neoplasia, and some other malignancies. Cancer cells reduce the expression of l-asparaginase leading to their elimination. The l-asparaginase anticancerous application approach has made incredible breakthrough in the field of modern oncology through depletion of plasma l-asparagine to inhibit the cancer cells growth; particularly among children. High level of l-asparaginase enzyme production by Escherichia coli, Erwinia species, Streptomyces, and Bacillus subtilis species is highly desirable as bacterial alternative enzyme sources for anticancer therapy. Thermal or harsh conditions stability of those from the two latter bacterial species is considerable. Some enzymes from marine bacteria have conferred stability in adverse conditions being more advantageous in cancer therapy. Several side effects exerted by l-asparaginases such as hypersensitivity should be hindered or decreased through alternative therapies or use of immune-suppressor drugs. The l-asparaginase from Erwinia species has displayed remarkable traits in children with this regard. Noticeably, Erwinia chrysanthemi l-asparaginase exhibited negligible glutaminase activity representing a promising efficiency mitigating related side effects. Application of software such as RSM would optimize conditions for higher levels of enzyme production. Additionally, genetic recombination of the encoding gene would indisputably help improving enzyme traits. Furthermore, the possibility of anticancer combination therapy using two or more l-asparaginases from various sources is plausible in future studies to achieve better therapeutic outcomes with lower side effects.

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Natural killer (NK) cells have significant capability in tumor immune-surveillance. The ability of lyse transformed cells immediately in an antigen-independent manner make them an attractive candidate for cancer cell therapy. Despite employment of NK cells in cancer immunotherapy, clinical trials are faced with serious limitations such as trouble with the penetration of NK cells in tumor sites, limited in vivo persistence, and tumor microenvironment interference. Taken together, the NK-cell cancer therapy is still infant scenario that has a long way to be translated in clinic. Current article first reviews characteristic features of NK lymphocytes. Then, it discusses about important disruptive barriers and motivator in the developmental stages of NK cells like as tumor microenvironment. Finally, some revolutionary approaches are highlighted utilizing of NK cells in cancer therapy.