Logotherapy to improve parent-child relationship among mothers of autistic children: a randomized clinical trial.

OBJECTIVE: Autism spectrum disorders are characterized by three characteristics: impairment in the quality of social relationships, severe impairment in communication, and restricted, repetitive behavioral patterns. The aim of this research is to determine the effect of logotherapy on the parent-child relationship among mothers of autistic children. PATIENTS AND METHODS: This research is a clinical trial with pre-test, post-test design, and control group. Forty mothers were selected and randomly assigned into two groups of intervention and control. The intervention group attended 10 sessions (90 min) of logotherapy, twice a week, while the control group received the routine intervention. A mother-child relationship evaluation questionnaire was used to collect data. SPSS statistical software was employed to analyze the data. RESULTS: The results showed that group logotherapy training affects the parent-child relationship in mothers of autistic children. We only examined the relatively short-term effects of logotherapy on parents' and children's outcomes because after the children's school year ended, their mothers did not refer to the center. In order to achieve accurate results, we recommend examining the long-term effects of this approach in future studies. CONCLUSIONS: Logotherapy is an effective approach to improve the parent-child relationship in mothers of autistic children.

Stages of grieving in fathers of autistic children: a qualitative study.

OBJECTIVE: The grieving process in parents of these children is an ongoing and cyclic one since there is no real end to it. We explored the experience of grief and feelings of loss in fathers of children diagnosed with autism spectrum disorder (ASD), in the west and northwest of Iran. MATERIALS AND METHODS: This qualitative study was conducted using content analysis. Fourteen fathers took part in a semi-structured interview. RESULTS: Six categories were identified in relation to the stages of grief: 1- "Uncertainty of dealing with the unpleasant unknown"; 2- "Being hurt and broken inside"; 3- "Isolation and concealment as a consequence of the pressure caused by ignorance"; 4- "Search for cause"; 5- "Search for a cure"; 6- "Breaking or blooming". CONCLUSIONS: Fathers of children with ASD go through intense and continuous sorrow and grief. According to our findings, it is recommended that health care professionals work collaboratively with fathers and provide support upon receiving the diagnosis of their child.

Prevalence of androgen deficiency in chronic spinal cord injury patients suffering from erectile dysfunction.

STUDY DESIGN: Retrospective cross-sectional study. OBJECTIVES: To estimate the prevalence of biochemical androgen deficiency in Iranian spinal cord injured men suffering from erectile dysfunction (ED) and to determine factors related to this problem. SETTING: An andrology clinic of a teaching hospital in Tehran. METHODS: Men, 18 years of age and older, with chronic (>2 years) spinal cord injury (SCI) suffering from ED were recruited. Demographic data, hormonal and lipid levels, injury variables and drug history were obtained from the medical records. The relationships between biochemical androgen deficiency (unequivocally low serum testosterone levels) and patient characteristics, injury variables and laboratory data were determined. RESULTS: Out of 319 patients, 32.6% had total testosterone deficiency and 29.1% had biochemical androgen deficiency. Of those with biochemical androgen deficiency, 93.5 and 85.7% had luteinizing hormone (LH) and follicle stimulating hormone (FSH) within or below the normal ranges, respectively. Opioid use, triglyceride (TG) and total cholesterol (TC) were associated with biochemical androgen deficiency. Significant correlations between total testosterone level and sex hormone binding globulin (r=0.3, P<0.001), LH (r=0.2, P=0.02), TC (r=-0.1, P=0.04) and TG (r=-0.3, P<0.001) were found. CONCLUSION: A substantial proportion of our patients with chronic SCI and ED had biochemical androgen deficiency. Opioid use, TG and TC levels were associated with biochemical androgen deficiency in our studied population. Standard screening of androgen deficiency and testosterone replacement therapy are recommended in men with chronic SCI suffering from ED. SPONSORSHIP: Tehran University of Medical Sciences.

Turbulent life: the experiences of the family members of patients suffering from depression.

Families of patients suffering from depression have an important role in provision of care to the patients, which also may impose a great amount of stress on them. The purpose of this study was to explore and describe the experiences of the family members of patients suffering from depression on the impact of provision of care to the patients. A qualitative design using a content analysis approach was used to gather and analyse data. Unstructured interviews were conducted with 26 family members of patients suffering from depression chosen using purposeful sampling. During data analysis, 'turbulent life' was developed as the main theme along with five other categories including: 'penetration of the illness in the family', 'daily life's hardship', 'too much attention to the patient', 'delay in the acceptation of the illness' and 'concern about the patient's current and future conditions'. Each category consisted of several subcategories. It is concluded that the psychological, physical and financial factors imposed on families result in 'turbulent life'. Nurses can reduce the burden of providing care to patients suffering from depression through improving the knowledge of family members about how to communicate with patients and increase emotional supportive resources to the patients and their family members.

Relationship of respiratory sounds to alterations in the upper airway resistance.

Respiratory sound analysis is a simple and noninvasive way to study the pathophysiology of the upper airway (UA). Recently, it has been used to diagnose partial or complete UA collapse in patients with obstructive sleep apnea (OSA). In this study, we investigated whether uid accumulation in the neck alters the properties of respiratory sounds in temporal and spectral domains and whether the respiratory sounds analysis can be used to monitor variations in the physiology of the UA, as re ected by UA resistance (R(UA)). We recorded respiratory sounds and R(UA) from 19 individuals while awake. We applied lower body positive pressure (LBPP) to shift uid out of the legs and into the neck, which increased R(UA). We calculated !rst and second formants and energy of inspiratory sound segments. Our results show that during both control (no LBPP) and LBPP arms of the study, the extracted features were different for the sound segments corresponding to low and high R(UA). Also, the features were different during control and LBPP arms of the study. With the application of support vector machine (SVM) based classi!er, we were able to classify the sound segments into two groups of high/low resistance during control and LBPP arms and into two groups of control/LBPP when including all sound segments. The accuracies of non-linear SVM classi!er were 74.5 ± 19.5%, 75.0 ± 15.4% and 77.1 ± 12.3% for the control arm, LBPP arm and between the arms, respectively. We also showed that during the LBPP arm, the variations in !rst formant of the sound segments corresponding to low and high R(UA) was much less than during the control arm. This indicates that with application of LBPP and accumulation of uid in the neck, there are less variations in the morphology of the UA in response to changes in R(UA), than during the control arm. These results indicate that acoustic analysis of respiratory sounds can be used to investigate physiology of the UA and how interventions can alter UA properties.

Computational prediction of intronic microRNA targets using host gene expression reveals novel regulatory mechanisms.

Approximately half of known human miRNAs are located in the introns of protein coding genes. Some of these intronic miRNAs are only expressed when their host gene is and, as such, their steady state expression levels are highly correlated with those of the host gene's mRNA. Recently host gene expression levels have been used to predict the targets of intronic miRNAs by identifying other mRNAs that they have consistent negative correlation with. This is a potentially powerful approach because it allows a large number of expression profiling studies to be used but needs refinement because mRNAs can be targeted by multiple miRNAs and not all intronic miRNAs are co-expressed with their host genes.Here we introduce InMiR, a new computational method that uses a linear-Gaussian model to predict the targets of intronic miRNAs based on the expression profiles of their host genes across a large number of datasets. Our method recovers nearly twice as many true positives at the same fixed false positive rate as a comparable method that only considers correlations. Through an analysis of 140 Affymetrix datasets from Gene Expression Omnibus, we build a network of 19,926 interactions among 57 intronic miRNAs and 3,864 targets. InMiR can also predict which host genes have expression profiles that are good surrogates for those of their intronic miRNAs. Host genes that InMiR predicts are bad surrogates contain significantly more miRNA target sites in their 3' UTRs and are significantly more likely to have predicted Pol II and Pol III promoters in their introns.We provide a dataset of 1,935 predicted mRNA targets for 22 intronic miRNAs. These prediction are supported both by sequence features and expression. By combining our results with previous reports, we distinguish three classes of intronic miRNAs: Those that are tightly regulated with their host gene; those that are likely to be expressed from the same promoter but whose host gene is highly regulated by miRNAs; and those likely to have independent promoters.

Laparoscopic partial nephrectomy for tumours >4 cm compared with smaller tumours: perioperative results.

OBJECTIVE: The use of laparoscopic partial nephrectomy (LPN) in patients with tumours >4 cm remains to be further evaluated. We report our experience with LPN in tumours >4 cm compared with tumours ≤4 cm. MATERIALS AND METHODS: This is a retrospective study of data from all LPN patients operated from 2003 to 2008. Inclusion criteria were a single organ confined contrast enhancing mass/Bosniac III-IV cyst. Hospital admission records were used to extract operative and follow-up data. Patients were grouped into group A: ≤4 cm (32 patients, 53% of total), and group B: >4 cm (28 patients, 47% of total). RESULTS: A total of 60 patients (mean ± SD age, 47.4 ± 13.4 years; M/F, 36/24) were included. Mean ± SD tumour size was 31.5 ± 7.3 mm and 51.6 ± 10.9 mm in groups A and B, respectively. (P < 0.001) Malignant pathology was present in 22 (69%) and 16 patients (57%) in groups A and B, respectively. (P > 0.05) There was no statistically significant difference in age, gender, pre-operative creatinine, estimated glomerular filtration rate (eGFR), and other investigated pre-operative characteristics between study groups. (all P > 0.05) Nor any difference was observed regarding operative and pathologic (warm ischaemia time, operation duration, transfusion, positive margins, and malignant histology) as well as post-operative variables (re-hospitalization, post-operative complications, hospital stay, or eGFR changes). CONCLUSION: The results of this study supports the feasibility and comparability of operative and post-operative early complications for LPN when applied to tumours >4 cm in selected patients compared with tumours ≤4 cm.

Predicting the target genes of intronic microRNAs using large-scale gene expression data.

Current microRNA target prediction techniques provide long lists of putative miRNA-target interactions, many of which are false positives. The goal of this paper is to identify functional targets in these lists based on biological evidence obtained from the expression profiles of the host genes of intronic miRNAs and those of their targets. We propose a scoring strategy for each interaction based on the combinatorial effect of miRNAs. In particular, the change in expression level of a target gene is expressed in terms of a linear combination of the host gene data which are used as surrogates for expression data of the intronic miRNAs. The parameters of this linear model give an estimate of the contribution of each intronic miRNA in down-regulating the target gene. The experimental results show that our prediction technique is able to detect several functional interactions. In addition, the analysis of mRNA microarrays after intronic miRNA transfection confirms that significantly down-regulated genes are among targets detected by our technique.

Effects of pentoxifylline on oxidative stress and levels of EGF and NO in blood of diabetic type-2 patients; a randomized, double-blind placebo-controlled clinical trial.

BACKGROUND: As oxidative stress contributes to both progression and pathologic complications of diabetes and effective therapeutic strategies to prevent or delay the damage remain limited, the aim of the present study was to assess the efficacy of pentoxifylline in reducing of oxidative stress. Since there is a relationship between nitric oxide (NO), epidermal growth factor (EGF) and oxidative stress, we measured the effect of this drug on these parameters in comparison to placebo. METHODS: Thirty-nine patients with type-2 diabetes mellitus were randomized in a double blind, placebo-controlled clinical trial to receive either pentoxifylline 400 mg four times a day or placebo for 14 days. Blood samples were obtained at baseline and at the end of the study. Samples were analyzed for thiobarbituric reactive substances (TBARS) as a marker of lipid peroxidation, ferric reducing ability (total antioxidant power, TAP), EGF and NO levels. RESULTS: Pentoxifylline in comparison to placebo was effective (P < 0.05) in reduction of lipid peroxidation in plasma of the patients without significant effects on TAP, levels of EGF and NO in plasma. CONCLUSION: Adding of pentoxifylline to drug regimen of diabetic type-2 patients can be helpful. Exact mechanism of action of pentoxifylline in reduction of blood lipid peroxidation remains to be elucidated.