Spinal Reirradiation-Mediated Myelopathy: A Systematic Review and Meta-Analysis

Reirradiation of the spine is carried out in 42% of patients who do not respond to treatment or have recurrent pain. However, there are few studies and data on the effect of reirradiation of the spine and the occurrence of acute and chronic side-effects caused by reirradiation, such as myelopathy, in these patients. This meta-analysis aimed to determine the safe dose in terms of biological effective dose (BED), cumulative dose and dose interval between BED1 and BED2 to decrease or prevent myelopathy and pain control in patients undergoing radiation therapy in the spinal cord. A search was carried out using EMBASE, MEDLINE, PUBMED, Google Scholar, Cochrane Collaboration library electronic databases, Magiran, and SID from 2000 to 2022 to recognise qualified studies. In total, 17 primary studies were applied to estimate the pooled effect size. The random effects model showed that the pooled BED in the first stage, the BED in the second stage and the cumulative BED1 and BED2 were estimated at 77.63, 58.35 and 115.34 Gy, respectively. Studies reported on dose interval. The results of a random effects model showed that the pooled interval was estimated at 13.86 months. The meta-analysis revealed that using appropriate BED1 and/or BED2 in a safe interval between the first and second phases of treatment can have an influential role in preventing or reducing the effects of myelopathy and regional control pain in spinal reirradiation.

Prevalence of pre-eclampsia and adverse pregnancy outcomes in women with pre-existing cardiomyopathy: a multi-centre retrospective cohort study

Pre-eclampsia is associated with postnatal cardiac dysfunction; however, the nature of this relationship remains uncertain. This multicentre retrospective cohort study aimed to determine the prevalence of pre-eclampsia in women with pre-existing cardiac dysfunction (left ventricular ejection fraction < 55%) and explore the relationship between pregnancy outcome and pre-pregnancy cardiac phenotype. In this cohort of 282 pregnancies, pre-eclampsia prevalence was not significantly increased (4.6% [95% C.I 2.2-7.0%] vs. population prevalence of 4.6% [95% C.I. 2.7-8.2], p = 0.99); 12/13 women had concurrent obstetric/medical risk factors for pre-eclampsia. The prevalence of preterm pre-eclampsia (< 37 weeks) and fetal growth restriction (FGR) was increased (1.8% vs. 0.7%, p = 0.03; 15.2% vs. 5.5%, p < 0.001, respectively). Neither systolic nor diastolic function correlated with pregnancy outcome. Antenatal ß blockers (n = 116) were associated with lower birthweight Z score (adjusted difference - 0.31 [95% C.I. - 0.61 to - 0.01], p = 0.04). To conclude, this study demonstrated a modest increase in preterm pre-eclampsia and significant increase in FGR in women with pre-existing cardiac dysfunction. Our results do not necessarily support a causal relationship between cardiac dysfunction and pre-eclampsia, especially given the population's background risk status. The mechanism underpinning the relationship between cardiac dysfunction and FGR merits further research but could be influenced by concomitant ß blocker use.

Maternal Cardiac Changes in Women With Obesity and Gestational Diabetes Mellitus

OBJECTIVE

We investigated if women with gestational diabetes mellitus (GDM) in the third trimester of pregnancy exhibit adverse cardiac alterations in myocardial energetics, function, or tissue characteristics.

RESEARCH DESIGN AND METHODS

Thirty-eight healthy, pregnant women and 30 women with GDM were recruited. Participants underwent phosphorus MRS and cardiovascular magnetic resonance for assessment of myocardial energetics (phosphocreatine [PCr] to ATP ratio), tissue characteristics, biventricular volumes and ejection fractions, left ventricular (LV) mass, global longitudinal shortening (GLS), and mitral in-flow E-wave to A-wave ratio.

RESULTS

Participants were matched for age, gestational age, and ethnicity. The following data are reported as mean ± SD. The women with GDM had higher BMI (27 ± 4 vs. 33 ± 5 kg/m2; P = 0.0001) and systolic (115 ± 11 vs. 121 ± 13 mmHg; P = 0.04) and diastolic (72 ± 7 vs. 76 ± 9 mmHg; P = 0.04) blood pressures. There was no difference in N-terminal pro-brain natriuretic peptide concentrations between the groups. The women with GDM had lower myocardial PCr to ATP ratio (2.2 ± 0.3 vs. 1.9 ± 0.4; P < 0.0001), accompanied by lower LV end-diastolic volumes (76 ± 12 vs. 67 ± 11 mL/m2; P = 0.002) and higher LV mass (90 ± 13 vs. 103 ± 18 g; P = 0.001). Although ventricular ejection fractions were similar, the GLS was reduced in women with GDM (-20% ± 3% vs. -18% ± 3%; P = 0.008).

CONCLUSIONS

Despite no prior diagnosis of diabetes, women with obesity and GDM manifest impaired myocardial contractility and higher LV mass, associated with reductions in myocardial energetics in late pregnancy compared with lean women with healthy pregnancy. These findings may aid our understanding of the long-term cardiovascular risks associated with GDM.

Gestational diabetes, preeclampsia and the maternal heart

Background

Gestational diabetes mellitus (GDM) and preeclampsia (pE) are both associated with an increased risk of cardiovascular mortality and morbidity, including an increased risk of developing heart failure in later life. Both conditions are increasing in prevalence; GDM affects up to 12% and pE affects 3–5% of pregnancies worldwide. Compromised cardiac energy production is an important contributor to most forms of heart disease. The changes in myocardial energetics in GDM and pE have not been characterised previously.

Purpose

We sought to assess if women with GDM and women with pE in the third trimester of pregnancy exhibit adverse cardiac alterations in myocardial energetics, function or tissue characteristics.

Methods

Thirty-eight healthy pregnant (HP) women, thirty women with GDM and fifteen women with pE were recruited, matched for age and ethnicity. Participants underwent phosphorus magnetic resonance spectroscopy and cardiovascular magnetic resonance for assessment of myocardial energetics (phosphocreatine to ATP ratio (PCr/ATP)), tissue characteristics, biventricular volumes and ejection fractions, left ventricular (LV) mass, global longitudinal strain (GLS) and mitral in-flow E/A ratio.

Results

The biochemical characteristics and multiparametric MR results are given in Table 1.

The women in the GDM and the pE groups had higher body-mass index. There was a stepwise increase in the systolic and diastolic BP from the HP to the GDM to the pE group. There was no difference in NTproBNP concentrations between the groups. The gestational weight gain was higher in women with GDM and pE compared to the HP group.

The women in the GDM and the pE groups showed similar reductions in myocardial PCr/ATP ratios compared to HP group (Figure 1a), accompanied by lower LV end-diastolic volumes and higher LV mass (Figure 1b) and enhanced LV concentricity in both groups (Figure 1c). While LV ejection fractions were similar across the groups, the GLS was reduced in women with GDM and in women with pE (Figure 1d).

Conclusions

We show here for the first time that despite no prior diagnosis of diabetes or hypertension, women with GDM or pE manifest impaired myocardial contractility and higher LV mass, associated with reductions in myocardial energetics. These findings may aid our understanding of the long-term cardiovascular risks associated with these conditions.

Funding Acknowledgement

Type of funding sources: Foundation. Main funding source(s): Wellcome Trust

Explore the antiproliferative phytocompounds from ethanolic extracts of Citrus paradisi against liver cancer cell line by chemical analysis using TLC and FT-IR spectroscopy

The aim of the present study was to evaluate the in vitro antiproliferative activity of ethanolic extract of leaves and fruits Citrus paradisi plant on HepG-2 liver cell lines by MTT (3-(4, 5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-terazolium bromide) assay and to isolate and characterize the antiproliferative compounds by TLC (Thin layer chromatography) and FT-IR (Fourier transforms Infrared) spectroscopy. Qualitative phytochemical screening tests were performed to detect phytochemicals compounds from the crude extracts. Antioxidant activity of the plant extracts were characterized by using DPPH (2,2-Diphenyl-1-picrylhydrazyl) free radical scavenging method. The results showed that antioxidant activity using DPPH were found to be increased in a concentration dependent manner and decreased cell viability and cell growth inhibition in a dose dependent manner. The findings from this study indicated that fruit extract exhibited good antiproliferation and antioxidant potential. The seven functional groups of phytocompounds such as carboxylic acid, amine salt, aromatic compounds, cyclic alkene, aldehyde, fluoro compounds and alkene were detected by FT-IR which indicated that fruit extracts of Citrus paradisi possessed vast potential as a medicinal drug especially in liver cancer treatment.

The effect of motivational interview based on WhatsApp on the psychological domains of quality of life in infertile women with pcos: A randomized clinical trial

Introduction

Polycystic ovary syndrome(Pcos) disease significantly decreased quality of life for women. Mental health is one of the components affecting the quality of life of these patients that attention to it is necessary to improve their quality of life.

Objectives

The present study was conducted to determine The effect of Motivational Interview Based on WhatsApp on the Psychological Domains of Quality of Life in Infertile Women with PCOS.

Methods

This randomized controlled clinical trial enrolled 60 Infertile Women with PCOS from the city of Sari-Iran in 2020. Participants were assigned to MI and control groups using block randomization. The intervention group received 5 weekly of MI online via WhatsApp. While the control group received only routine care. The psychological Domains score of quality of life in these individuals was measured using the quality of life questionnaire of polycystic ovary syndrome(MPCOSQ) before and after the intervention. Then, the data were entered into the SPSS software, version 25 and were analyzed using descriptive statistics, chi-square test, t-test, and repeated measures analysis of variance.

Results

No significant difference was observed between the two groups before the intervention mean The Psychological Domains scores (p>0.05). After the intervention, mean (SD) of The Psychological Domains score was 34.8 (11.8) in the intervention group and 30.7 (11.6) in the control.No significant Increasing in the mean between the two groups. The effect size(0.35) was calculated.

Conclusions

The results of the study showed that motivational interviewing is effective in improving the quality of life of women with pcos.

Disclosure

No significant relationships.

The effect of online motivational interviewing on stress management in infertile women with PCOS: A randomized clinical trial

Introduction

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women, which in addition to medical aspects also affects the dimensions of women’s mental health such as stress.

Objectives

The present study was conducted to determine The effect of online motivational interviewing on stress management in infertile women with PCOS

Methods

This randomized controlled clinical trial enrolled 60 Infertile Women with PCOS from the city of Sari-Iran in 2020. Participants were assigned to MI and control groups using block randomization. The intervention group received 5 weekly of MI online via WhatsApp. While the control group received only routine care. Stress management scores in these individuals were measured using health-promoting lifestyle profile II questionnaire (HPLP II) before and after the intervention. Then, the data were entered into the SPSS software, version 25 and were analyzed using descriptive statistics, chi-square test, t-test, and repeated measures analysis of variance.

Results

No significant difference was observed between the two groups before the intervention mean The Stress management scores (p>0.05). After the intervention, mean (SD) of The Psychological Domains score was 22.5 (3.8) in the intervention group and 17.9 (4.1) in the control. The Stress management score was significantly upper in the intervention group compared to the control. (p<0.000). The effect size (1.1) was calculated. NNT (1.6) was calculated.

Conclusions

According to the results and the effect of motivational interviewing is one of the effective methods to manage stress in infertile women with PCOS.

Disclosure

No significant relationships.

Effect of emulsifiers on drying stress and intercellular cohesion in human stratum corneum

OBJECTIVES

Emulsifier molecules, with their amphiphilic character, are ubiquitous in moisturizing creams and primarily serve to disperse the water-insoluble molecules such as emollients, oils, lipids and fats in water. The objective of this study was to investigate the effect of emulsifier molecules on the barrier and biomechanical properties of human stratum corneum (SC) and to compare the efficacy of emulsifier molecules when used in a fully formulated moisturizing cream.

METHODS

We employed methods based on thin-film mechanics to measure the drying stress and intercellular cohesion in the SC. The emulsifier molecules or moisturizing creams formulated with them were applied to a fully hydrated SC adhered to a glass substrate. In-plane stress developed in the SC during drying was then measured by tracking changes in the curvature of the glass substrate. The intercellular cohesion within the SC was measured by means of a double cantilever beam (DCB) set-up, where the treated or untreated SC was sandwiched between two substrates, and the delamination energy calculated by measuring the force required to drive a crack through the SC. Moisturizing cream diffusivity through the stratum corneum was measured by spectroscopic technique and related to internal SC stress and fracture energy.

RESULTS

We observe significant differences in the biomechanical behaviour of SC when moisturizing creams with different emulsifier molecules are applied on isolated stratum corneum ex vivo. The reduction in maximum stress varied between 12% and 26% depending on the emulsifier molecules used in the formulation. The intercellular cohesion and the diffusion of molecules in the formulated moisturizing creams through the SC were also found to be strongly dependent on the type of emulsifier molecule used in the formulation.

CONCLUSIONS

The biomechanical and barrier properties of the human stratum corneum show strong dependence on the emulsifier molecule used in the moisturizing creams, even when the creams included only ~3 weight% emulsifier molecules. Moreover, we found that the reduction in SC peak stress was strongly correlated with the formulation diffusivity into the SC. The moisturizing creams diffusing fastest into the SC had the largest reduction in peak stress and vice versa.

Nematic structuring of transparent and multifunctional nanocellulose papers

The nematic structuring of cellulose nanofibers (CNFs) is proposed as a nanostructural engineering tool for exploiting the potential of CNFs in conceptually new "transparent papers". The nematic-structured CNF papers exhibit superior mechanical properties, optical transparency, gas-barrier properties, heat transfer properties and electrical resistivity, compared with conventional randomly-structured CNF papers.

Modifying effect of intravenous laser therapy on the protein expression of arginase and epidermal growth factor receptor in type 2 diabetic patients

The epidermal growth factor receptor (EGFR) signaling pathway may be involved in cell activation and may influence the neuronal microenvironment, microglia activation, and production of proinflammatory cytokines. Arginase and nitric oxide synthase (NOS) both use L-arginine as a common substrate. Decreasing the arginase expression may increase L-arginine consumption by NOS and increase nitric oxide (NO) synthesis. Intravenous laser blood irradiation (ILBI) is an effective systemic treatment for different pathologies including diabetes mellitus. Previous studies have shown that low-level laser therapy can have an effect on the release of certain cytokines and growth factors. The aim of this study was to evaluate the effects of ILBI on the expression of arginase and epidermal growth factor receptor in type 2 diabetic patients. We used 630 nm red laser light, 1.5 mW, continuous mode, intravenously for 30 min in 13 type 2 diabetic patients and compared their blood samples using the flow cytometry technique, before and after ILBI. The difference between the percentage of cells before and after therapy was analyzed using repeated-measures ANOVA, and the relationship between EGFR and arginase expression in blood and tissue was evaluated by calculating the Pearson correlation coefficient. We found a significant decrease in the expression of both arginase- and EGFR-positive cells after laser therapy (P < 0.01). In conclusion, laser therapy may have a beneficial effect for diabetic patients via decreasing arginase expression and activation of the NOS/NO pathway which increases NO production and vasodilation, and decreasing EGFR expression which may reduce neuroinflammation and its secondary damages.

Improvement in the corrosion resistance of stainless steel 304L in sodium chloride solution by a nanoclay incorporated silane coating

An eco-friendly silane sol–gel coating incorporating nanoclay was formulated to provide an effective corrosion protection for stainless steel 304L in a NaCl solution.

DBT degradation enhancement by decorating Rhodococcus erythropolis IGST8 with magnetic Fe3O4 nanoparticles

Biodesulfurization (BDS) of dibenzothiophene (DBT) was carried out by Rhodococcus erythropolis IGST8 decorated with magnetic Fe3O4 nanoparticles, synthesized in-house by a chemical method, with an average size of 45-50 nm, in order to facilitate the post-reaction separation of the bacteria from the reaction mixture. Scanning electron microscopy (SEM) showed that the magnetic nanoparticles substantially coated the surfaces of the bacteria. It was found that the decorated cells had a 56% higher DBT desulfurization activity in basic salt medium (BSM) compared to the nondecorated cells. We propose that this is due to permeabilization of the bacterial membrane, facilitating the entry and exit of reactant and product, respectively. Model experiments with black lipid membranes (BLM) demonstrated that the nanoparticles indeed enhance membrane permeability.

Clonal identity of Candida albicans in the oral cavity and the gastrointestinal tract of pre-school children

The clonal relationship between oral and fecal Candida albicans isolated from children of pre-school age was examined using RAPD analysis. Significantly higher levels of C. albicans were found in saliva, dental plaque, carious specimens and stools of 56 patients with severe caries as compared to 52 healthy control subjects. The highest prevalence was found in carious specimens and a strong correlation was observed between its presence in saliva, dental plaque, carious specimen and feces. RAPD analysis of isolates from 23 patients with simultaneous oral and fecal C. albicans revealed clonal counterparts present in both oral and stool samples in 15 cases; five patients harbored closely related strains; and three patients harbored unrelated strains. Our results demonstrate a strong correlation between oral and gastrointestinal C. albicans colonization. We assume that carious teeth may constitute an ecologic niche for C. albicans potentially responsible for recurrent oral and non-oral candidiasis.

Application of attenuated total reflectance Fourier transform infrared spectrometry to the determination of cephalosporin C in complex fermentation broths

An analytical procedure has been developed for quantitative determination of cephalosporin C in complex fermentation broths. The method is based on the partial least-square treatment of data obtained by attenuated total reflectance Fourier transform infrared (ATR-FTIR) spectrometric method in the wavenumber range of 1227-1257 cm(-1). Absorbance spectra were employed for measurement using a set of eleven binary aqueous standard solutions of cep halosporin C and deacetoxycephalosporin C. The method is simple, rapid and accurate (to within +/-1.49%). The developed method has been used to measure cephalosporin C in aqueous solution of biosynthetic samples only after freeze drying the sample at -30 degrees C and dissolving it in distilled water.

Utilization review of systemic antiinfective agents in a teaching hospital in Tehran, Iran

OBJECTIVES

To investigate the pattern of systemic antiinfective use in Bouali teaching hospital (BH) within a standardized methodology.

METHODS

To perform a standardized and repeatable study, the Anatomic-Therapeutic-Chemical classification and defined daily dose (ATC/DDD) methodology was used for the first time in Iran. The number of systemic antiinfectives (J class) prescribed for inpatients over a period of 6 months was converted to DDDs. DDD per 100 bed-days was used as a quantitative indicator, and the expenditure share of these drugs was computed. Data were compared with those of similar studies in other countries.

RESULTS

Total prescription of systemic antiinfectives was 101.92 DDD/100 bed-days, of which 62% related to parenteral forms. 58% to broad-spectrum agents, and 40.2% to broad-spectrum parenteral agents. The five most commonly used drugs were ampicillin, cefazolin, ceftizoxime, gentamicin, and cefalexin. Antiinfectives prescribed for inpatients accounted for 25.2% of total drug sales of the hospital pharmacy. Most prescriptions occurred in infectious diseases ward. followed by the intensive care unit, gynecology, obstetrics, and ear-nose-throat wards.

CONCLUSION

Prescribing patterns in different wards, relationships between use and cost. and monthly variations are identified and discussed. High utilization rate and irrational prescription of antiinfectives in BH, along with inadequate hospital and national drug policies may be concluded from this study. Drug utilization research study is a useful tool to highlight patterns of drug use.

Use of systemic anti-infective agents in Iran during 1997-1998

OBJECTIVE

Conduction of standardized national drug utilization review to investigate the pattern of systemic anti-infective agent use in Iran.

METHODS

The wholesale data were used. The Anatomical Therapeutic Chemical (ATC) classification and the defined daily dose (DDD) methodology was employed. Data were presented as DDD/1,000 inhabitants"day. Results were compared using national drug statistics of Norway, Sweden, and Denmark.

RESULTS

The overall sales of systemic anti-infective agents was 43.5 DDD/1,000 inhabitants/day. The parenteral form of drug accounted for 4.20% and broad-spectrum systemic antibacterial agents accounted for 86.2%. The three most commonly used agents, accounting for 74.1% of total sales, were amoxicillin, co-trimoxazole, and ampicillin. Seven kinds of anti-infective agents (17% of total available agents) accounted for 90% of antibacterial use, with dominance of broad-spectrum agents. Comparison showed differences in pattern and intensity of use. The sales of systemic anti-infective agents in general, particularly antibacterials and anti-tuberclotics, were greater in Iran than in three European countries. Broad-spectrum antibacterial agents accounted for a larger proportion of total sales in Iran.

CONCLUSION

The high use of systemic antibacterial agents in general, particularly broad-spectrum agents, suggest the possibility of irrational prescribing, higher prescribed daily doses than DDDs, and a drug wastage. This survey, as a first attempt, provided an overview of anti-infective use in Iran. Thus, it may serve as a basis for further investigative studies and advanced drug policies.

Iron status and socioeconomic determinants of the quantity and quality of dietary iron in a group of rural Iranian women

Iron intake and status were investigated in 471 mothers (age range: 16-53 years) from rural areas in Khorramabad, Islamic Republic of Iran. Although average total iron intake was acceptable, only 6.4% of women derived at least 4% of their total intake from animal iron. Average energy and protein intakes were inadequate. Low iron status was seen in 8.2%-28.7%, depending on the parameter used, with 28.3% experiencing iron-deficiency anaemia. Significantly higher animal iron intakes were found in literate or employed women, or those of family size fewer than six people. Increasing employment opportunities, income levels and literacy rates for women will result in better iron intake and status and should receive particular attention in national planning.

Quasi-distributed fiber-optic strain sensor: principle and experiment

Sensors capable of making distributed measurements allow for monitoring of the entire structure. Optical fiber sensors are especially attractive for this purpose, since they are geometrically versatile and can be readily integrated within various types of structure and material. Development and characteristics of a quasi-distributed intrinsic fiber-optic strain sensor based on white-light interferometry are described. The research presented here describes the development of a new optical fiber sensor system for measurement of structural strains based on double white-light interferometry. Individual segments of single-mode optical fibers forming a common-path interferometer are linked in series, and a scanning white-light interferometer provides for distributed sensing of strain signals from various locations in the structure. The system is configured for automatic compensation of drift due to environmental effects, i.e., temperature and vibration. Strain gauges were employed for comparison and verification of strain signals as measured by the new system. The experimental results demonstrate the linearity of the system and the capability for distributed sensing of strains.

Intrauterine torsion of a wandering spleen presenting as an abdominal cystic swelling

Wandering spleen is a rare clinical condition that presents commonly with splenic infarction secondary to torsion. Intrauterine torsion of a wandering spleen, however, is extremely rare. An unusual case of intrauterine torsion of a wandering spleen presenting as an abdominal mass is reported.

Fiber-optic refractive-index sensor for use in fresh concrete

We describe the development of a portable fiber-optic refractive-index sensor for detecting the air-bubble content in fresh concrete. The sensor uses a low-power visible laser diode as the light source. Data processing is performed in real time by a lap-top microcomputer. We introduce a new digital image-processing methodology for the interpretation of reflected-light intensity signals. Sensor performance is examined through laboratory and field studies on concrete poured at actual highway sites.

Controlled trial of the prolactin inhibitor bromocriptine (Parlodel) in the treatment of severe cyclical mastalgia

Fifty pre-menopausal women with severe and persistent cyclical mastalgia entered this randomised, double-blind, parallel group study comparing bromocriptine and placebo. Patients were treated for three months followed by a further three months on the same medication if treatment was satisfactory. Symptoms were assessed before treatment and after one, two and three months of treatment. For patients whose mastalgia was not controlled after three months, the treatment code was broken and either the dose of bromocriptine increased or the patient given active medication instead of placebo. Bromocriptine, compared with placebo, caused a significant (p less than 0.01) and sustained improvement in breast pain, tenderness and nodularity together with a reduction in serum prolactin levels (p less than 0.01). Adverse events were experienced by 9/23 (39 per cent) of patients taking bromocriptine and 2/22 (nine per cent) taking placebo. The majority of side effects reported were mild or moderate. This study shows that bromocriptine, at a dose of 5 mg/day for three months, effectively controls the symptoms of cyclical mastalgia with minimal side effects.

Automated fringe measurement in speckle photography

An automated Young's fringe processor for point filtering of speckle photographs is described. It automatically measures the magnitude and direction of displacements from fringe densities of less than twenty with good accuracies. Microcomputer-based, requiring <64K of memory, the system provides full automation by employing computer-controlled scanning.