Restoring Endogenous Repair Mechanisms to Heal Chronic Wounds with a Multifunctional Wound Dressing.

Current treatment of chronic wounds has been critically limited by various factors, including bacterial infection, biofilm formation, impaired angiogenesis, and prolonged inflammation. Addressing these challenges, we developed a multifunctional wound dressing-based three-pronged approach for accelerating wound healing. The multifunctional wound dressing, composed of nanofibers, functional nanoparticles, natural biopolymers, and selected protein and peptide, can target multiple endogenous repair mechanisms and represents a promising alternative to current wound healing products.

Is there a relationship between non-obstructive coronary artery disease or cardiac syndrome X and migraine? An integrated multi-disciplinary approach.

Non-obstructive coronary artery disease (CAD) which is mostly called cardiac syndrome X (CSX) is noted in about 30% of men and 40%-60% of women and seems to be incremental. In addition, frequent myocardial perfusion defects with various levels of severity are often seen in this disease. Recently, we noticed that the frequency of migraine in patients with CSX was noticeably higher than in healthy people and in CAD patients. This may support the evolving story that CSX is related to migraine and to chest pain and that CSX and migraine may have a similar pathophysiology. Hence, myocardial perfusion imaging could be used as a complement any diagnostic test to support the relation between CSX and migraine.

Transulnar versus transradial approach for coronary angiography and angioplasty: Considering their complications.

BACKGROUND: Transulnar approach was introduced as an alternative procedure for transradial coronary angiography (CAG) due to its safety and feasibility. The present study was accomplished with the aim to compare major and minor complications of these two upper extremity approaches in the population under study. METHODS: In this prospective observational study, 216 patients who underwent CAG and/or angioplasty via radial (111 cases) or ulnar artery (105 cases) were observed and followed for 6 months and were evaluated for major adverse cardiac events (MACEs), minor and major neurovascular events (access related) of the arm including paresthesia/pain, pseudoaneurysm, artery spasm, arterial occlusion, large hematoma, and necessity for amputation or emergency surgery. RESULTS: The majority of patients were men (62.1%) with a mean age of 59.98 ± 9.74 years old. No MACEs and major life threatening vascular complication like large hematoma, need for amputation or surgery, and hand ischemia were occurred. There was no significant difference in minor complications, except for arterial occlusion 9.0 % vs 1.0 % and artery spasm 12.6 % vs 1.9 % in transradial and transulnar approaches, respectively (P < 0.05). CONCLUSION: This study suggested that both transradial and transulnar approaches were safe and feasible for CAG and/or angioplasty. However, regarding minor complications, arterial spasm and occlusion were significantly more common in transradial approach.

Distal accesses in the hand (two novel techniques) for percutaneous coronary angiography and intervention.

BACKGROUND: Trans-radial and trans-ulnar accesses have been practiced and recommended as default and alternative techniques for coronary angiography and angioplasty in recent years. In this study, we present new innovative approaches using more distal access points, i.e. trans-snuff box and trans-palmar approaches. METHODS: We conducted dorsal hand access (trans-snuff box) for angiography and/or angioplasty on 235 patients, and trans-palmar access (superficial palmar branch of ulnar artery) on 175 patients in 3 hospitals in Isfahan City, Iran. RESULTS: In 221 patients out of 235 ones (94.1%) [men: 76.5%, age: 57.4 ± 10.4 (years); women: 23.5%, age: 62.4 ± 9.5 (years)], our procedure through snuff box (dorsal hand) was successfully performed. In 159 patients out of 175 ones (90.8%) [men: 76.0%, age: 58.1 ± 10.5 (years); women: 24.0%, age: 61.2 ± 9.6 (years)], our procedure through palmar artery was successfully performed. In total, the evaluated patients had mild pain (3.4% for snuff box, and 4.5% for palmar), ecchymosis in distal forearm (5.1% for snuff box, and 2.8% for palmar), with no major complications even one (amputation, infection, thrombosis, need for surgery, hand dysfunction, nerve palsy, and so forth). In addition, percutaneous coronary intervention (PCI) was done in 28.9% and 18.2% of cases via snuff box and palmar approaches, respectively. Meanwhile, hemostasis was very fast and easy with discharge time equivalent to other upper limb accesses. CONCLUSION: Although our procedures are at their early stages with about a follow-up period of 3-15 months, more researches are recommended to be conducted in forthcoming months and years, and this new innovative approaches could be suggested safe, feasible, and reliable with low complications.

Modeling of Individual and Organizational Factors Affecting Traumatic Occupational Injuries Based on the Structural Equation Modeling: A Case Study in Large Construction Industries.

BACKGROUND: Individual and organizational factors are the factors influencing traumatic occupational injuries. OBJECTIVES: The aim of the present study was the short path analysis of the severity of occupational injuries based on individual and organizational factors. MATERIALS AND METHODS: The present cross-sectional analytical study was implemented on traumatic occupational injuries within a ten-year timeframe in 13 large Iranian construction industries. Modeling and data analysis were done using the structural equation modeling (SEM) approach and the IBM SPSS AMOS statistical software version 22.0, respectively. RESULTS: The mean age and working experience of the injured workers were 28.03 ± 5.33 and 4.53 ± 3.82 years, respectively. The portions of construction and installation activities of traumatic occupational injuries were 64.4% and 18.1%, respectively. The SEM findings showed that the individual, organizational and accident type factors significantly were considered as effective factors on occupational injuries' severity (P < 0.05). CONCLUSIONS: Path analysis of occupational injuries based on the SEM reveals that individual and organizational factors and their indicator variables are very influential on the severity of traumatic occupational injuries. So, these should be considered to reduce occupational accidents' severity in large construction industries.

Comparison of 180° and 360° Arc Data Acquisition to Measure Scintigraphic Parameters from Gated Single Photon Emission Computed Tomography Myocardial Perfusion Imaging: Is There Any Difference?

OBJECTIVE: The aim of the current study was to compare 180° and 360° data collection modes to measure end diastolic volume (EDV), end systolic volume (ESV) and ejection fraction (EF) values of the cardiac system by gated myocardial perfusion tomography. METHODS: Thirty-three patients underwent gated myocardial perfusion tomography. Single photon emission computed tomography data of patients' heart were acquired by 180°, 45° left posterior oblique to 45° right anterior oblique, and 360° to obtain EDV, ESV, EF and cardiac volume changes (V1, V2, V3, V4, V5, V6, V7 and V8) throughout each cardiac cycle. RESULTS: Results of the current study indicated that there were no significant differences between 180° and 360° angular sampling in terms of measuring EDV, ESV and EF in myocardial perfusion imaging. Cardiac volume change patterns during a cardiac cycle were also similar in 360° and 180° scans. We also observed that there was no difference in EDV, ESV and EF values between the group with stress induced by exercise and the group with stress imposed by dipyridamole. CONCLUSION: As there is no difference between 180°and 360° cardiac scanning in terms of EDV, ESV and EF, half-orbit scan is recommended to study these cardiac system parameters because it offers more comfort to patients and a shorter scanning time.