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In the suggested optical fiber-based magnetoplasmonic system, we investigated the magnetic properties of graphene/nickel nanostructures. The plasmonic mode changes under the magnetic field observed in the intensity diagrams over time. To be accessible, cheap, and portable, we used a smartphone as a detector and processor. Considering the ambient noise and the light source, it was reported that the intensity of the changes improved up to 5 times. Further, the clad corrosion experiment carried out by pure dimethyl ketone in an intensity modulation by a smartphone camera and 10 seconds suggested removing fluorine polymer clad.
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BACKGROUND: Dental caries is considered a major global health issue and among the most challenging diseases worldwide. An effective way of preventing dental caries is the fissure sealant (FS) therapy. OBJECTIVE: To determine the effectiveness of an educational intervention developed based on the health belief model (HBM) for parents' perception of FS therapy for their children. METHODS: Quasi-experiment among 300 parents of 6-12 year-old children, 150 in the intervention group (IG) and 150 in the control (CG), in the south of Iran recruited via both clustering and convenience sampling. Data were collected using a validated questionnaire collecting demographic information, knowledge and data on HBM constructs and FS behaviour. Eight intervention sessions, 40-60 minutes long, were held for over month. The primary outcome was child's receipt of fissure sealants 3 months after the intervention. RESULTS: The two groups had similar knowledge and the HBM constructs at baseline. After the intervention, the receipt of FS therapy was 65% and 12% in the IG and CG, respectively (p ⟨ 0.001, Chi Sq.). ANCOVA supported post-test differences between the intervention and control groups when accounting for baseline scores (p⟨0.05). CONCLUSIONS: The educational HBM-based intervention improved parents' perceptions and their children's receipt of FS therapy. The intervention affected the HBM constructs. Barriers to healthy oral/dental behaviours may be reduced by interventions at multiple layers (beyond the individual level).
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Caries Dental , Humanos , Niño , Caries Dental/prevención & control , Selladores de Fosas y Fisuras/uso terapéutico , Encuestas y Cuestionarios , Padres , PercepciónRESUMEN
BACKGROUND: Emergency colorectal cancer surgery is associated with significant mortality. Induced adrenergic hyperactivity is thought to be an important contributor. Downregulating the effects of circulating catecholamines may reduce the risk of adverse outcomes. This study assessed whether regular preoperative beta-blockade reduced mortality after emergency colonic cancer surgery. METHODS: This cohort study used the prospectively collected Swedish Colorectal Cancer Registry to recruit all adult patients requiring emergency colonic cancer surgery between 2011 and 2016. Patients were subdivided into those receiving regular beta-blocker therapy before surgery and those who were not (control). Demographics and clinical outcomes were compared. Risk factors for 30-day mortality were evaluated using Poisson regression analysis. RESULTS: A total of 3187 patients were included, of whom 685 (21·5 per cent) used regular beta-blocker therapy before surgery. The overall 30-day mortality rate was significantly reduced in the beta-blocker group compared with controls: 3·1 (95 per cent c.i. 1·9 to 4·7) versus 8·6 (7·6 to 9·8) per cent respectively (P < 0·001). Beta-blocker therapy was the only modifiable protective factor identified in multivariable analysis of 30-day all-cause mortality (incidence rate ratio 0·31, 95 per cent c.i. 0·20 to 0·47; P < 0·001) and was associated with a significant reduction in death of cardiovascular, respiratory, sepsis and multiple organ failure origin. CONCLUSION: Preoperative beta-blocker therapy may be associated with a reduction in 30-day mortality following emergency colonic cancer surgery.
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Antagonistas Adrenérgicos beta/uso terapéutico , Colectomía/mortalidad , Neoplasias del Colon/mortalidad , Neoplasias del Colon/cirugía , Sistema de Registros , Adulto , Factores de Edad , Anciano , Estudios de Cohortes , Colectomía/métodos , Neoplasias del Colon/patología , Urgencias Médicas , Femenino , Humanos , Masculino , Cadenas de Markov , Persona de Mediana Edad , Complicaciones Posoperatorias/mortalidad , Complicaciones Posoperatorias/prevención & control , Cuidados Preoperatorios , Estudios Retrospectivos , Medición de Riesgo , Factores Sexuales , Estadísticas no Paramétricas , Tasa de Supervivencia , Suecia , Resultado del TratamientoRESUMEN
Novel processing sequences for the fabrication of artificial nanostructures are in high demand for various applications. In this paper, we report on a fine-tunable nano-machining technique for the fabrication of 3D hollow nanostructures. This technique originates from redeposition effects occurring during Ar dry etching of nano-patterns. Different geometries of honeycomb, double ring, nanotube, cone and crescent arrays have been successfully fabricated from various metals such as Au, Ag, Pt and Ti. The geometrical parameters of the 3D hollow nanostructures can be straightforwardly controlled by tuning the discharge plasma pressure and power. The structure and morphology of nanostructures are probed using atomic force microscopy (AFM), scanning electron microscopy (SEM), optical emission spectroscopy (OES) and energy dispersive x-ray spectroscopy (EDS). Finally, a Ag nanotube array was assayed for application in surface enhanced Raman spectroscopy (SERS), resulting in an enhancement factor (EF) of 5.5 × 105, as an experimental validity proof consistent with the presented simulation framework. Furthermore, it was found that the theoretical EF value for the honeycomb array is in the order of 107, a hundred times greater than that found in nanotube array.
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In the rapidly developing area of magnetoionics (MI), which combines electrochemistry and magnetism, changes in the surface chemistry of magnetic materials in response to gate voltages cause dramatic modifications in the magnetic characteristics, resulting in low power-consuming charge transport tuning. Due to the surficial character, only magnetic thin films have been addressed for the MI effect's role in controlling charge transfer. Here, we show how it can be used to regulate the transit of charges in bulk magnetic materials. This is accomplished by combining high-permeability magnetic materials with a high-frequency passing current, allowing the skin effect and the MI effect to control the magnetic materials' impedance due to the impedance's high sensitivity to magnetic permeability. Our in-situ impedance measurement and magneto-optical characterization show the role of redox reactions at the surface in controlling impedance in magnetic materials. This research paves the way for using the MI effect in high-permeability bulk magnetic materials.
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It has been argued that if multiple spin wave modes are competing for the same centrally located energy source, as in a nanocontact spin torque oscillator, that only one mode should survive in the steady state. Here, the experimental conditions necessary for mode coexistence are explored. Mode coexistence is facilitated by the local field asymmetries induced by the spatially inhomogeneous Oersted field, which leads to a physical separation of the modes, and is further promoted by spin wave localization at reduced applied field angles. Finally, both simulation and experiment reveal a low frequency signal consistent with the intermodulation of two coexistent modes.
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Enhancing the electrical conductivity of liquid crystal (LC) circumvents challenges for application in advanced electronic components. Toward this, using additives made of different nanostructures that could result in functional LCs is suggested. In this paper, various concentrations of graphene (Gr)/metal-oxide (Fe3O4) nanocomposite (GMN) (0.0001-1 w%) were added to E7 nematic LC. We found that the role of anisotropic Gr flakes, their edges as well as surface-decorated-metal-oxide-additives have significant impact on electrical properties of E7. A range of appropriate additives of such a nanocomposite enhances the electrical conductivity of LCs. This effect can be traced through the decrease in the formation of GMN aggregates in the E7 and increase in the electrostatic field at the edges of the Gr sheets. Moreover, the presence of metal-oxide nanoclusters due to the presence of oxygen vacancies and defects facilitates the construction of conductive network for improving the charge transfer pathways and contributes to a stronger interaction of the Gr surface with charged species. These factors can provide Gr layers as dipole moments and lead to signal propagation in the dielectric medium. Our finding conveys a pathway toward significant enhancement of electrical conductivity in the LC family which can be useful for functional applications.
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BACKGROUND: breast cancer (BC) is the most common malignancy among Iranian women. Although the relative incidence of BC is low, the cause-specific mortality is much higher than developed countries. The present study surveyed the overall trend of BC in Tehran. PATIENTS AND METHODS: all breast pathologic records were studied in five major hospitals in Tehran during three phases (1: 1985-1995; 2: 1996-2000; and 3: 2001-2005). Malignant cases were classified according to the tumor-node-metastasis classification. Data were compared across the study. RESULTS: Of 9050 medical records from male and female patients with 'breast disease', 2946 females with BC were included. A significant increase in the diagnosis of palpable early BCs (stage II increased, stage III decreased) was observed between phases 1 and 2. A relative increases in stages 0 and I were noted between phases 3 and 2. Nevertheless, 76.8% of cases were T2 or higher and 65.3% had positive lymph nodes in the last phase. The proportion of patients with stage IIIb was increased in phase 3, despite the reduction in phase 2. CONCLUSIONS: despite the relative improvement in the status of BC patients, the vast majority are diagnosed in advanced stages. Specific screening measures should be implemented in Iran.
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Neoplasias de la Mama Masculina/epidemiología , Neoplasias de la Mama/epidemiología , Adulto , Neoplasias de la Mama/patología , Neoplasias de la Mama Masculina/patología , Detección Precoz del Cáncer , Femenino , Humanos , Irán/epidemiología , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Adulto JovenRESUMEN
BACKGROUND AND AIMS: Emergency laparotomy is associated with a great risk of mortality in the elderly. The hyperadrenergic state induced by surgical trauma may play an important role in the pathophysiology of this increased risk. Studies have shown that beta-blocker exposure may be associated with decreased morbidity and mortality in the perioperative period. We aimed to study the effect of beta-blocker on mortality in geriatric patients undergoing emergency laparotomy. MATERIAL AND METHODS: This is a retrospective study of patients who underwent emergency laparotomy between 1 January 2015 and 31 December 2016 at a single institution. The outcomes of interest were the association between post-operative complications and in-hospital and 1-year mortality in patients on beta-blocker therapy (BB(+)) and those who were not (BB(-)). The Poisson regression analysis was used to evaluate the association. RESULTS: A total of 192 patients were included of whom 62 (32.2%) had pre-operative beta-blocker therapy with continued exposure during their hospital stay. The in-hospital mortality was 17.7% in the BB(+) and 23.8% in the BB(-) cohorts (p = 0.441). One-year mortality was significantly lower in the BB(+) group compared to the BB(-) group (30.6% versus 47.7%; p = 0.038). After adjusting for confounders, the incidence of deaths during 1 year post-operatively decreased by 35% in the BB(+) group (incidence rate ratio = 0.65, p = 0.004). No significant differences in the incidence of post-operative complications between the two groups could be measured. CONCLUSION: Beta-blocker therapy may be associated with reduced 1-year mortality following emergency laparotomy in geriatric patients.
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Antagonistas Adrenérgicos beta/uso terapéutico , Mortalidad Hospitalaria , Laparotomía/métodos , Complicaciones Posoperatorias/mortalidad , Anciano , Anciano de 80 o más Años , Urgencias Médicas , Femenino , Humanos , Masculino , Estudios Retrospectivos , Factores de RiesgoRESUMEN
BACKGROUND: Despite advances in perioperative care, the postoperative mortality rate after emergency oncological colonic resection remains high. Risk stratification may allow targeted perioperative optimization and cardiac risk stratification. This study aimed to test the hypothesis that the Revised Cardiac Risk Index (RCRI), a user-friendly tool, could identify patients who would benefit most from perioperative cardiac risk mitigation. METHODS: Patients who underwent emergency resection for colonic cancer from 2007 to 2017 and registered in the Swedish Colorectal Cancer Registry (SCRCR) were analysed retrospectively. These patients were cross-referenced by social security number to the Swedish National Board of Health and Welfare data set, a government registry of mortality, and co-morbidity data. RCRI scores were calculated for each patient and correlated with 90-day postoperative mortality risk, using Poisson regression with robust error of variance. RESULTS: Some 5703 patients met the study inclusion criteria. A linear increase in crude 90-day postoperative mortality was detected with increasing RCRI score (37.3 versus 11.3 per cent for RCRI 4 or more versus RCRI 1; P < 0.001). The adjusted 90-day all-cause mortality risk was also significantly increased (RCRI 4 or more versus RCRI 1: adjusted incidence rate ratio 2.07, 95 per cent c.i. 1.49 to 2.89; P < 0.001). CONCLUSION: This study documented an association between increasing cardiac risk and 90-day postoperative mortality. Those undergoing emergency colorectal surgery for cancer with a raised RCRI score should be considered high-risk patients who would most likely benefit from enhanced postoperative monitoring and critical care expertise.
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Neoplasias del Colon , Complicaciones Posoperatorias , Neoplasias del Colon/cirugía , Humanos , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos , Medición de Riesgo , Factores de RiesgoRESUMEN
BACKGROUND: Complicated acute biliary calculous disease poses clinical challenges. The European Society of Trauma and Emergency Surgery (ESTES) snapshot audit of complicated biliary calculous disease aims to make novel comparisons between self-reported institutional adherence to the Tokyo guidelines (TG18) and 'real-world' contemporary practice across Europe. METHODS: A preplanned analysis of a prospective observational multicentre audit that captured patients undergoing emergency admission for complicated biliary calculous disease (complicated cholecystitis, biliary pancreatitis, or choledocholithiasis with or without cholangitis) between 1 and 31 October 2018 was performed. An anonymized survey was administered to participating sites. RESULTS: Following an open call for participation, 25 centres from nine countries enrolled 338 patients. All centres completed the anonymized survey. Fifteen centres (60 per cent) self-reported that a minority of patients were treated surgically on index admission, favouring interval cholecystectomy. This was replicated in the snapshot audit, in which 152 of 338 patients (45·0 per cent) underwent index admission cholecystectomy, 17 (5·0 per cent) had interval cholecystectomy, and the remaining 169 (50·0 per cent) had not undergone surgery by the end of the 60-day follow-up. Centres that employed a dedicated acute care surgery model of care were more likely to perform index admission cholecystectomy compared with a traditional general surgery 'on call' service (57 versus 38 per cent respectively; odds ratio 2·14 (95 per cent c.i. 1·37 to 3·35), P < 0·001). Six centres (24 per cent) self-reported routinely performing blood cultures in acute cholecystitis; patient-level audit data revealed that blood cultures were done in 47 of 154 patients (30·5 per cent). No centre self-reported omitting antibiotics in the management of acute cholecystitis, and 144 of 154 (93·5 per cent) of patients in the snapshot audit received antibiotics during their index admission. CONCLUSION: Awareness of TG18 recommendations was high, but self-reported adherence and objective snapshot audit data showed low compliance with TG18 in patients with complicated acute biliary calculous disease.
ANTECEDENTES: La complicación aguda de la litiasis biliar (complicated acute biliary calculous disease, CABCD) plantea retos clínicos. Esta auditoría de la Sociedad Europea de Trauma y Cirugía de Urgencias (European Society of Trauma and Emergency Surgery, ESTES) de la CABCD tuvo como objetivo comparar el conocimiento teórico de las recomendaciones de Tokio (TG18) y la "práctica real" en Europa. MÉTODOS: Se efectuó un análisis pre-establecido de los datos de una auditoría prospectiva, observacional y multicéntrica que incluyó los pacientes ingresados de urgencia por CABCD (es decir, colecistitis complicada, pancreatitis biliar o coledocolitiasis con o sin colangitis) entre el 1 y el 31 de octubre de 2018. Además, se realizó una encuesta anónima en los centros participantes. RESULTADOS: Tras una convocatoria abierta, 25 centros de 9 países incluyeron 338 pacientes. Todos los centros completaron la encuesta anónima. El 60% de los centros reconocieron que trataban en el mismo ingreso una minoría de los pacientes y que favorecían la colecistectomía diferida. Ello se reprodujo en la auditoria, donde a 152/338 (44,9%) de los pacientes se realizó la colecistectomía en el mismo ingreso, a 17/338 (5%) se realizó una colecistectomía diferida y que a 169/338 (50%) todavía no se había realizado ninguna intervención en los 60 días de seguimiento. Los centros que seguían el Modelo de Atención Quirúrgica Urgente tenían mayores probabilidades de realizar la colecistectomía en el mismo ingreso en comparación con un servicio de cirugía general tradicional 'de guardia' (57% versus 38,4%, razón de oportunidades, odds ratio, OR 2,14 (i.c. del 95% 1,37-3,35), P < 0,001)). El 24% de los centros afirmaron realizar hemocultivos de rutina en la colecistitis aguda. Sin embargo, los datos de la auditoría revelaron que solamente 47/154 (30,5%) de los pacientes tenían hemocultivos. Ningún centro declaró no administrar antibióticos en el tratamiento de la colecistitis aguda, mientras que 144/154 (93,5%) de los pacientes de la auditoría no recibieron antibióticos durante el ingreso. CONCLUSIONES: El conocimiento de las recomendaciones de TG18 fue alto. Sin embargo, la observancia reconocida por los centros y los datos objetivos de la auditoría muestran que el cumplimiento en los pacientes con CABCD es bajo.
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Colecistectomía Laparoscópica/métodos , Colecistitis Aguda/cirugía , Enfermedades de la Vesícula Biliar/cirugía , Adhesión a Directriz , Autoinforme , Anciano , Anciano de 80 o más Años , Colecistectomía Laparoscópica/efectos adversos , Colecistitis Aguda/diagnóstico por imagen , Femenino , Enfermedades de la Vesícula Biliar/diagnóstico por imagen , Encuestas de Atención de la Salud , Hospitalización , Humanos , Internacionalidad , Masculino , Persona de Mediana Edad , Estudios Prospectivos , TokioRESUMEN
Maternal autoantibodies to the p200-epitope of Ro52 have been suggested to correlate with development of congenital heart block. The aim of the present study was to evaluate the clinical relevance and predictive value of p200-antibodies in high-risk pregnancies. Sera from 515 Finnish, Swedish and American women were included in the study. Sera originated from 202 mothers with an infant affected by second- or third-degree atrioventricular block (AVB), 177 mothers with rheumatic disease having infants with normal heart rate and female blood donors (n = 136). A novel serological assay for Ro52 p200-antibodies with intra- and inter-assay variability of 3% and 3.8% respectively was developed. Mothers of children affected by AVB II-III had significantly higher p200-antibody levels than mothers with rheumatic disease having children with normal heart rate (P < 0.001). In the Swedish cohort, a distinction between foetuses with normal conduction, AVB I, AVB II and III was possible. A significant difference in anti-p200 levels between AVB I and AVB II-III groups compared with foetuses with normal conduction (P < 0.05 and P < 0.01) was observed. Using p200-antibodies as a second step analysis in Ro52-positive pregnancies increased the positive predictive value for foetal cardiac involvement (AVB I, II or III) from 0.39 (0.27-0.51) to 0.53 (0.37-0.68). In conclusion, Ro52 p200-antibodies may occur in women with unaffected children, but levels are significantly higher in mothers of children with congenital heart block and are suggested as a relevant marker in evaluating the risk for foetal AV block.
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Autoanticuerpos/sangre , Proteínas Activadoras de GTPasa/inmunología , Bloqueo Cardíaco/congénito , Bloqueo Cardíaco/inmunología , Ribonucleoproteínas/química , Adulto , Análisis de Varianza , Bloqueo Atrioventricular/inmunología , Autoanticuerpos/inmunología , Biomarcadores/sangre , Estudios de Casos y Controles , Ensayo de Inmunoadsorción Enzimática/métodos , Femenino , Finlandia , Humanos , Embarazo , Factores de Riesgo , Suecia , Estados UnidosRESUMEN
The spin Hall effect (SHE) has shown promising impact in the field of spintronics and magnonics from fundamental and practical points of view. This effect originates from several mechanisms of spin scatterers based on spin-orbit coupling (SOC) and also can be manipulated through the surface roughness. Here, the effect of correlated surface roughness on the SHE in metallic thin films with small SOC is investigated theoretically. Toward this, the self-affine fractal surface in the framework of the Born approximation is exploited. The surface roughness is described by the k-correlation model and is characterized by the roughness exponent H [Formula: see text], the in-plane correlation length ξ and the rms roughness amplitude δ. It is found that the spin Hall angle in metallic thin film increases by two orders of magnitude when H decreases from H = 1 to H = 0. In addition, the source of SHE for surface roughness with Gaussian profile distribution function is found to be mainly the side jump scattering while that with a non-Gaussian profile suggests both of the side jump and skew scatterings are present. Our achievements address how details of the surface roughness profile can adjust the SHE in non-heavy metals.
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A dissipative magnetic soliton, or magnetic droplet, is a structure that has been predicted to exist within a thin magnetic layer when non-linearity is balanced by dispersion, and a driving force counteracts the inherent damping of the spin precession. Such a soliton can be formed beneath a nano-contact (NC) that delivers a large spin-polarized current density into a magnetic layer with perpendicular magnetic anisotropy. Although the existence of droplets has been confirmed from electrical measurements and by micromagnetic simulations, only a few attempts have been made to directly observe the magnetic landscape that sustains these structures, and then only for a restricted set of experimental parameter values. In this work we use and x-ray holography technique HERALDO, to image the magnetic structure of the [Co/Ni]x4 multilayer within a NC orthogonal pseudo spin-valve, for different range of magnetic fields and injected electric currents. The magnetic configuration imaged at -33 mA and 0.3 T for devices with 90 nm NC diameter reveals a structure that is within the range of current where the droplet soliton exist based on our electrical measurements and have it is consistent with the expected size of the droplet (â¼100 nm diameter) and its spatial position within the sample. We also report the magnetisation configurations observed at lower DC currents in the presence of fields (0-50 mT), where it is expected to observe regimes of the unstable droplet formation.
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PURPOSE: Severe traumatic brain injury (TBI) is the predominant cause of death and disability following trauma. Several studies have observed improved survival in TBI patients exposed to ß-blockers, however, the effect on functional outcome is poorly documented. METHODS: Adult patients with severe TBI (head AIS ≥ 3) were identified from a prospectively collected TBI database over a 5-year period. Patients with neurosurgical ICU length of stay <48 h and those dying within 48 h of admission were excluded. Patients exposed to ß-blockers ≤ 48 h after admission and who continued with treatment until discharge constituted ß-blocked cases and were matched to non ß-blocked controls using propensity score matching. The outcome of interest was Glasgow Outcome Scores (GOS), as a measure of functional outcome up to 12 months after injury. GOS ≤ 3 was considered a poor outcome. Bivariate analysis was deployed to determine differences between groups. Odds ratio and 95% CI were used to assess the effect of ß-blockers on GOS. RESULTS: 362 patients met the inclusion criteria with 21% receiving ß-blockers during admission. After propensity matching, 76 matched pairs were available for analysis. There were no statistical differences in any variables included in the analysis. Mean hospital length of stay was shorter in the ß-blocked cases (18.0 vs. 26.8 days, p < 0.01). The risk of poor long-term functional outcome was more than doubled in non-ß-blocked controls (OR 2.44, 95% CI 1.01-6.03, p = 0.03). CONCLUSION: Exposure to ß-blockers in patients with severe TBI appears to improve functional outcome. Further prospective randomized trials are warranted.
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Antagonistas Adrenérgicos beta/uso terapéutico , Lesiones Traumáticas del Encéfalo/tratamiento farmacológico , Antagonistas Adrenérgicos beta/administración & dosificación , Lesiones Traumáticas del Encéfalo/mortalidad , Lesiones Traumáticas del Encéfalo/rehabilitación , Estudios de Casos y Controles , Femenino , Escala de Coma de Glasgow , Humanos , Puntaje de Gravedad del Traumatismo , Tiempo de Internación , Masculino , Persona de Mediana Edad , Recuperación de la Función , Análisis de Supervivencia , SueciaRESUMEN
Environmental isolation of black yeasts potentially causing human disorders is essential for understanding ecology and routes of infection. Several Exophiala species show prevalence for man-made environments rich in monoaromatic compounds, such as creosote-treated or petroleum-stained railway sleepers. Ambient climatic conditions play a role in species composition in suitable habitats. Therefore, the aim of the present study was to establish the composition of Exophiala species in railway stations as a potential source of human infections in a subtropical region with evaluation of their antifungal susceptibility profiles. We examined 150 railway samples using cotton swabs moistened with sterile physiological saline. Black yeasts and relatives were selected on theirs colony morphology and identified based on ITS rDNA sequencing. Overall, 36 (24%) of samples were positive for black yeast-like fungi, i.e., Exophiala dermatitidis (n=20, 55.6%) was predominant, followed by E. phaeomuriformis (n=9, 25%), E. heteromorpha (n=5, 13.9%), and E. xenobiotica (n=2, 5.6%). Massive contaminations of E. dermatitidis were seen on railway sleepers on creosoted oak wood at the region close to the sea level, while in cold climates were primarily contaminated with clinically insignificant or rare human opportunists (E. crusticola). It seems that, high temperature and humidity are significant effect on species diversity. Moreover, the MIC results for all E. dermatitidis and E. phaeomuriformis strains revealed the widest range and the highest MICs to caspofungin (range 1-16mg/L, Geometric mean 4.912mg/L), and the lowest MIC for posaconazole (0.016-0.031mg/L, G mean 0.061mg/L). However, their clinical effectiveness in the treatment of Exophiala infections remains to be determined.
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Exophiala/aislamiento & purificación , Personas con Mala Vivienda/estadística & datos numéricos , Feohifomicosis/epidemiología , Feohifomicosis/microbiología , Vías Férreas , Antifúngicos/farmacología , ADN de Hongos/genética , Exposición a Riesgos Ambientales/estadística & datos numéricos , Exophiala/genética , Humanos , Irán/epidemiología , Pruebas de Sensibilidad Microbiana , Técnicas de Tipificación Micológica , Neuronas/microbiología , Prevalencia , Vías Férreas/estadística & datos numéricos , Características de la Residencia , Análisis de Secuencia de ADN , Microbiología del Suelo , TropismoRESUMEN
Symptomatic candiduria often occurs in patients with indwelling bladder catheters or immunocompromised host. Isolation of Candida in urine in high-risk patients should primarily be considered as a marker for candidemia. Hematological and genitourinary malignancies are one of the main risk factors associated with Candida urinary tract infections (CUTI). Fluconazole is a choice for initial treatment of CUTI, but it is fluctuate depending on the patient's condition including renal failure, site of urinary infection and Candida species. Poor glomerular filtration is the main disadvantage echinocandins resulting in very low urinary concentrations. Therefore, echinocandins have prohibited their use in CUTI. Up to now, there are only 10 cases reported in the literatures with highly effective echinocandins in CUTI because of high concentrations in the tissue are needed to control invasive fungal disease. Herein, we report a candiduria followed by renal candidiasis caused by Candida albicans in a 6-year-old Iranian male with a history of Wilms tumor in left kidney. Direct examination of urine specimen revealed an infection due to budding yeast cells with numerous pseudohyphae and growths of C. albicans was reconfirmed by sequencing of ITS rDNA region. MICs in increasing order were as follows: caspofungin (0.016µg/ml), voriconazole (0.125µg/ml), amphotericin B (0.25µg/ml), itraconazole (0.5µg/ml) and fluconazole (2µg/ml). It seems that successful treatment with caspofungin owes achieved high renal tissue concentrations that are unrelated to glomerular filtration. In conclusion, predisposing factors for better outcome are more important than treatment of CUTI, therefore, management of UTI is essential for critically patients.
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Candidiasis/tratamiento farmacológico , Equinocandinas/uso terapéutico , Neoplasias Renales/tratamiento farmacológico , Lipopéptidos/uso terapéutico , Infecciones Urinarias/tratamiento farmacológico , Tumor de Wilms/tratamiento farmacológico , Antifúngicos/uso terapéutico , Candida/aislamiento & purificación , Candidiasis/complicaciones , Candidiasis/orina , Caspofungina , Niño , Humanos , Irán , Neoplasias Renales/complicaciones , Neoplasias Renales/microbiología , Masculino , Resultado del Tratamiento , Infecciones Urinarias/complicaciones , Infecciones Urinarias/microbiología , Tumor de Wilms/complicaciones , Tumor de Wilms/microbiologíaRESUMEN
BACKGROUND AND PURPOSE: Vulvovaginal candidiasis is a frequent disease affecting approximately more than %75 of all childbearing women at least once in their lifetime by overgrowth of opportunistic Candida species. Recurrent vulvovaginal candidiasis (RVVC) is common in otherwise healthy individuals. Several risk factors were reported to contribute to RVVC susceptibility. A polymorphism in Dectin-1 (Y238X, rs16910526 ) was identified in patients with RVVC and hypothesized that genetic factors play an important role in susceptibility to RVVC. Herein, we aimed to survey the polymorphisms in the Dectin-1 gene, linked to susceptibility to RVVC. MATERIALS AND METHODS: In the current study, blood samples were obtained from 25 patients who had frequent vulvovaginal candidiasis relapses and were diagnosed as RVVC. In addition, blood cultures were obtained from control group comprising of healthy individuals (n=25) with no history of RVVC, vaginal discharge, or itching on the day of examination. Dectin-1 Y238X gene polymorphism was investigated using Bi-PASA and DNA sequencing. RESULTS: The analysis revealed that all of the patients were wild-type homozygous for Dectin-1 Y238X polymorphisms. None of the individuals showed heterozygous or mutant homozygous Dectin-1 polymorphism. CONCLUSION: No significant correlations were observed between the susceptibility to RVVC and Dectin-1 Y238X polymorphism in the Iranian population, which was not previously studied.
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Introduction: Given the ever-increasing importance and value of information, providing the management with a reliable information system, which can facilitate decision-making regarding planning, organization and control, is vitally important. This study aimed to analyze and evaluate the information needs of medical equipment offices. Methods: This descriptive applied cross-sectional study was carried out in 2010. The population of the study included the managers of statistic and medical records at the offices of vice-chancellor for treatment in 39 medical universities in Iran. Data were collected by using structured questioners. With regard to different kinds of designing information systems, sampling was done by two methods, BSP (based on processes of job description) and CSF method (based on critical success factors). The data were analyzed by SPSS-16. Results: Our study showed that 41% of information needs were found to be critical success factors of managers of office. The first priority of managers was "the number of bed and bed occupancy in hospitals". Of 29 identified information needs, 62% were initial information needs of managers (from the viewpoints of managers). Of all, 4% of the information needs were obtained through the form, 14% through both the form and database, 11% through the web site, and 71% had no sources (forms, databases, web site). Conclusion: Since 71% of the information needs of medical equipment offices managers had no information sources, the development of information system in these offices seems to be necessary. Despite the important role of users in designing the information systems (identifying 62% of information needs), other scientific methods is also needed to be utilized in designing the information systems.
RESUMEN
Road traffic accidents including intercity car traffic accidents (ICTAs) are among the most important causes of morbidity and mortality due to the growing number of vehicles, risky behaviors, and changes in lifestyle of the general population. A sound knowledge of the geographical distribution of car traffic accidents can be considered as an approach towards the accident causation and it can be used as an administrative tool in allocating the sources for traffic accidents prevention. This study was conducted to investigate the geographical distribution and the time trend of fatal intercity car traffic accidents in Iran. To conduct this descriptive study, all Iranian intercity road traffic mortality data were obtained from the Police reports in the Statistical Yearbook of the Governor's Budget and Planning. The obtained data were for 17 complete Iranian calendar years from March 1997 to March 2012. The incidence rate (IR) of fatal ICTAs for each year was calculated as the total number of fatal ICTAs in every 100000 population in specified time intervals. Figures and maps indicating the trends and geographical distribution of fatal ICTAs were prepared while using Microsoft Excel and ArcGis9.2 software. The number of fatal car accidents showed a general increasing trend from 3000 in 1996 to 13500 in 2012. The incidence of fatal intercity car accidents has changed from six in 100000 population in 1996 to 18 in 100000 population in 2012. GIS based data showed that the incidence rate of ICTAs in different provinces of Iran was very divergent. The highest incidence of fatal ICTAs was in Semnan province (IR= 35.2), followed by North Khorasan (IR=22.7), and South Khorasan (IR=22). The least incidence of fatal ICTAs was in Tehran province (IR=2.4) followed by Khozestan (IR=6.5), and Eastern Azarbayejan (IR=6.6). The compensation cost of fatal ICTAs also showed an increasing trend during the studied period. Since an increasing amount of money was being paid yearly for the car accidents, which were in their nature preventable, the key players in road safety including governments, car manufacturers, and road developers were recommended to use GIS based accident data for a more efficient planning and budgeting towards the intercity car accidents reduction.