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BACKGROUND: The stigma toward epilepsy is a daily challenge for people with epilepsy (PWE) and can influence the well-being and prognosis of these individuals. However, the cultural origins of such stigma have sparsely been examined. In this study, we aimed to investigate the classic Persian literature to gain insight into the historical and cultural beliefs and opinions regarding epilepsy as a determinant in developing stigma towards PWE. METHODS: In this narrative review of the classic Persian literature, we investigated the opinions and beliefs regarding epilepsy and PWE. In February 2023, we searched https://ganjoor.net (an open-access database of Iranian literature) for the relevant literary materials (poem and prose) using the Persian translation of the terms epilepsy (Sar'e) and epileptic (Masroo'e). Two clinical researchers went through the results and extracted the related materials under the supervision of two experts in Persian literature. A bilingual academic translated the included literary materials from Persian to English. RESULTS: Our search yielded 57 literature materials by 31 poets and writers from the 4th to 14th Hijri centuries, roughly coinciding with the past Gregorian millennium (1000-2000 AC). We classified the literary concepts related to epilepsy stigma into five subgroups: (i) a simile for pain and suffering; (ii) an atonement for blasphemous beliefs or a disease caused by supernatural power; (iii) a sign of madness, insanity, and lack of wisdom; (iv) a celestial observation; and (v) a subject for jokes. CONCLUSIONS: Classic Persian literature considered epilepsy as a simile for suffering and a sign of insanity that is caused by blasphemous beliefs or celestial objects, with PWE classified as insane and unwise. While such depictions became less prevalent after the 14th century CE, they can give rise to misconceptions and negative stigma toward PWE and should be addressed in modern culture. Each society should critically investigate its socio-cultural origins of stigma and rectify such misbeliefs.
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Epilepsia , Estigma Social , Humanos , Atitude , Irã (Geográfico)RESUMO
BACKGROUND: Coronavirus disease 2019 (COVID-19) has various sequelae, one of which might be hypertension. We aimed to evaluate COVID-19's impact on blood pressure (BP) in non-hospitalized patients at one-year follow-up. METHOD: A total of 7,950 consecutive COVID-19 patients regularly visiting our cardiology clinic were retrospectively screened. Patients' electronic medical records including demographics, comorbidities, vital signs, treatments, and outcomes, were reviewed by two physicians. Individuals with at least one BP measurement in the three months preceding COVID-19 and one measurement in 12 months or more following recovery were included. BP levels before and after COVID-19 were compared using the paired t-test. RESULTS: 5,355 confirmed COVID-19 patients (mean age 55.51 ± 15.38 years) were included. Hypertension (56.9%) and diabetes mellitus (34%) were the predominant comorbidities, and 44.3% had prior major adverse cardiovascular events. Both systolic (126.90 ± 20.91 vs. 139.99 ± 23.94 mmHg, P < 0.001) and diastolic BP (80.54 ± 13.94 vs. 86.49 ± 14.40 mmHg, P < 0.001) were significantly higher post-COVID-19 vs. pre-COVID-19. Notably, 456 (14%) hypertensive patients experienced exacerbated hypertension, while 408 (17%) patients developed new-onset hypertension, overall 864 (16%) of patients had exacerbation or new hypertension. Linear regression analysis revealed that advanced age, smoking, previous cardiovascular events, hypertension, and diabetes mellitus predict increased BP following COVID-19 (P < 0.001). CONCLUSION: COVID-19 raised systolic and diastolic BP in the long term in non-hospitalized patients, with over one-sixth developing new-onset or exacerbated hypertension. All patients should be evaluated regarding BP, following COVID-19 recovery, particularly those with the mentioned predictive factors. (clinicaltrial.gov: NCT05798208).
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Pressão Sanguínea , COVID-19 , Hipertensão , Humanos , COVID-19/diagnóstico , COVID-19/complicações , COVID-19/epidemiologia , COVID-19/fisiopatologia , Pessoa de Meia-Idade , Masculino , Feminino , Estudos Retrospectivos , Hipertensão/fisiopatologia , Hipertensão/epidemiologia , Hipertensão/diagnóstico , Idoso , Adulto , Fatores de Risco , Comorbidade , Fatores de Tempo , Seguimentos , SARS-CoV-2RESUMO
BACKGROUND: This study aimed to compare anthropometric indices to predict type 2 diabetes mellitus (T2DM) among first-degree relatives of diabetic patients in the Iranian community. METHODS: In this study, information on 3483 first-degree relatives (FDRs) of diabetic patients was extracted from the database of the Endocrinology and Metabolism Research Center of Isfahan University of Medical Sciences. Overall, 2082 FDRs were included in the analyses. A logistic regression model was used to evaluate the association between anthropometric indices and the odds of having diabetes. Furthermore, a receiver operating characteristic (ROC) curve was applied to estimate the optimal cutoff point based on the sensitivity and specificity of each index. In addition, the indices were compared based on the area under the curve (AUC). RESULTS: The overall prevalence of diabetes was 15.3%. The optimal cutoff points for anthropometric measures among men were 25.09 for body mass index (BMI) (AUC = 0.573), 0.52 for waist-to-height ratio (WHtR) (AUC = 0.648), 0.91 for waist-to-hip ratio (WHR) (AUC = 0.654), 0.08 for a body shape index (ABSI) (AUC = 0.599), 3.92 for body roundness index (BRI) (AUC = 0.648), 27.27 for body adiposity index (BAI) (AUC = 0.590), and 8 for visceral adiposity index (VAI) (AUC = 0.596). The optimal cutoff points for anthropometric indices were 28.75 for BMI (AUC = 0.610), 0.55 for the WHtR (AUC = 0.685), 0.80 for the WHR (AUC = 0.687), 0.07 for the ABSI (AUC = 0.669), 4.34 for the BRI (AUC = 0.685), 39.95 for the BAI (AUC = 0.583), and 6.15 for the VAI (AUC = 0.658). The WHR, WHTR, and BRI were revealed to have fair AUC values and were relatively greater than the other indices for both men and women. Furthermore, in women, the ABSI and VAI also had fair AUCs. However, BMI and the BAI had the lowest AUC values among the indices in both sexes. CONCLUSION: The WHtR, BRI, VAI, and WHR outperformed other anthropometric indices in predicting T2DM in first-degree relatives (FDRs) of diabetic patients. However, further investigations in different populations may need to be implemented to justify their widespread adoption in clinical practice.
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Diabetes Mellitus Tipo 2 , Masculino , Humanos , Feminino , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiologia , Irã (Geográfico)/epidemiologia , Antropometria , Índice de Massa Corporal , Adiposidade , ObesidadeRESUMO
Introduction: Takotsubo cardiomyopathy (TCM) features transient left ventricular apical dysfunction or ballooning. The underlying mechanism remains elusive; however, evidence suggests the role of different physical and psychological stressors. We systematically reviewed patients presenting with TCM and autoimmunity to explore the link between the two conditions. Methods: We applied the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) to report this review. Using keywords related to autoimmune/immune-mediated diseases and TCM, we searched PubMed, Scopus, and WOS in March 2022. The final results were added to a data extraction sheet. Data were analyzed by SPSS version 26.0. Results: Our search yielded 121 studies, including 155 patients. Females were considerably predominant. Most patients had a history of autoimmune disease, and almost a third had a history of cardiovascular disease. Dyspnea and chest pain were the most common chief complaints. More than 70% of patients had experienced physical stress. Myasthenia gravis, systemic lupus erythematosus, and multiple sclerosis were the most frequently reported autoimmune diseases. Conclusion: There were similarities in age and sex compared to classic TCM. TCM should be considered as a differential diagnosis for ACS, especially in patients with a positive background of autoimmunity. A precise reporting system is required for further studies.
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Doenças Autoimunes , Cardiomiopatia de Takotsubo , Humanos , Doenças Autoimunes/complicações , Doenças Autoimunes/diagnóstico , Dor no Peito , Estresse Psicológico , Cardiomiopatia de Takotsubo/diagnóstico , Estresse FisiológicoRESUMO
Background: Dual antiplatelet therapy with a P2Y12 inhibitor (e.g., clopidogrel and ticagrelor) and aspirin is recommended for at least one year after percutaneous coronary intervention (PCI) to prevent further myocardial infarction and stent thrombosis as the major adverse effects of PCI. Methods: This randomized clinical trial was conducted from October 2022 to March 2023. Patients who had undergone elective PCI were included in the study. Patients were randomized into two different groups. One group took ASA 80 mg and clopidogrel 75 mg once daily, while the other took ASA 80 mg once daily and ticagrelor 90 mg twice daily. After six months of close follow-up, patients were asked to score their dyspnea on a 10-point Likert scale. They were also asked about dyspnea on exertion, paroxysmal nocturnal dyspnea (PND), bleeding, and the occurrence of major adverse cardiovascular events (MACEs). Results: 223 patients were allocated to the clopidogrel group and 214 to the ticagrelor group. In the ticagrelor group, 95 patients (44.3%) reported dyspnea at rest, compared with only 44 patients (19.7%) in the clopidogrel group (P < 0.001). MACEs occurred in 7 patients (2.8%) in the ticagrelor group, compared with 16 (7.6%) in the clopidogrel group (P = 0.031). Eight patients (3.8%) reported bleeding with ticagrelor, as did seven (3.2%) with clopidogrel (P = 0.799). Conclusions: New-onset dyspnea was recorded more frequently with ticagrelor than clopidogrel, yet fewer MACEs occurred with ticagrelor (ClinicalTrials.gov number: NCT05858918).
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Síndrome Coronariana Aguda , Intervenção Coronária Percutânea , Humanos , Clopidogrel/efeitos adversos , Ticagrelor/uso terapêutico , Ticagrelor/efeitos adversos , Inibidores da Agregação Plaquetária/efeitos adversos , Intervenção Coronária Percutânea/efeitos adversos , Antagonistas do Receptor Purinérgico P2Y/efeitos adversos , Hemorragia/epidemiologia , Aspirina/uso terapêutico , Dispneia/etiologia , Stents , Síndrome Coronariana Aguda/terapia , Resultado do TratamentoRESUMO
BACKGROUND: Hepatic steatosis is an increasing complication in liver transplant recipients. Currently, there is no pharmacologic therapy for treatment of hepatic steatosis after liver transplantation. The aim of this study was to determine the association between use of angiotensin receptor blockers (ARB) and hepatic steatosis in liver transplant recipients. METHODS: We conducted a case-control analysis on data from Shiraz Liver Transplant Registry. Liver transplant recipients with and without hepatic steatosis were compared for risk factors including use of ARB. RESULTS: A total of 103 liver transplant recipients were included in the study. Thirty five patients treated with ARB and 68 patients (66%) did not receive these medications. In univariate analysis, ARB use (P = 0.002), serum triglyceride (P = 0.006), weight after liver transplantation (P = 0.011) and etiology of liver disease (P = 0.008) were associated with hepatic steatosis after liver transplantation. In multivariate regression analysis, ARB use was associated with lower likelihood of hepatic steatosis in liver transplant recipients (OR = 0.303, 95% CI: 0.117-0.784; P = 0.014). Mean duration of ARB use (P = 0.024) and mean cumulative daily dose of ARB (P = 0.015) were significantly lower in patients with hepatic steatosis. CONCLUSION: Our study showed that ARB use was associated with reduced incidence of hepatic steatosis in liver transplant recipients.
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Fígado Gorduroso , Transplante de Fígado , Humanos , Transplante de Fígado/efeitos adversos , Inibidores da Enzima Conversora de Angiotensina/efeitos adversos , Antagonistas de Receptores de Angiotensina/uso terapêutico , Fígado Gorduroso/etiologia , Fígado Gorduroso/prevenção & controle , Fatores de RiscoRESUMO
BACKGROUND: Besides the lungs, coronavirus disease 2019 (COVID-19) can affect the cardiovascular, digestive, urinary, hepatic, and central nervous systems. Other than its short-term effects, COVID-19 may also cause long-term complications. In this study, we assessed long-term COVID-19 cardiovascular symptoms among patients in a cardiovascular clinic. METHOD: A retrospective cohort was conducted between October 2020 to May 2021 on patients at an outpatient cardiovascular clinic in Shiraz, Iran. Patients with a history of COVID-19 at least one year before their referral were included. Baseline information was extracted from the clinic's database. Data were collected regarding symptoms like dyspnea, chest pain, fatigue, and palpitations after a year of COVID-19. We also noted any major adverse cardiac events (MACE). RESULTS: Most common symptoms after a year of COVID-19 were exertional dyspnea (51.2%), dyspnea at rest (41.6%), fatigue (39%), and chest pain (27.1%). The symptoms were more prevalent in hospitalized patients than in non-hospitalized patients. The prevalence of MACE was about 6.1% during the 12-month follow-up, with this rate being higher in those with a history of hospitalization or comorbid diseases. CONCLUSION: The prevalence of cardiovascular symptoms was fairly high in patients at our clinic a year after COVID-19, and the most common symptom was dyspnea. Hospitalized patients had more MACE. (Clinicaltrial.gov number: NCT05715879)(04/02/2023).
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COVID-19 , Humanos , Dor no Peito/diagnóstico , Dor no Peito/epidemiologia , Dor no Peito/etiologia , COVID-19/complicações , COVID-19/diagnóstico , Dispneia/diagnóstico , Dispneia/epidemiologia , Fadiga/diagnóstico , Fadiga/epidemiologia , Estudos RetrospectivosRESUMO
Acne vulgaris is a common condition, mostly involving teenagers. Post-acne scarring can cause many psychosocial problems. Treatments include topical agents, chemical peels, ablative lasers, fractional lasers, and more invasive approaches like subcision and surgery. We aimed to build on data regarding the efficacy and safety of endo-radiofrequency subcision in treating acne scars. This trial involved 30 patients (26 females and 4 males) suffering from acne scars. Patients were treated with endo-radiofrequency subcision. Outcomes were measured by Goodman and Baron scores (GBA), Patient's Global Assessment (PGA), and Investigator's Global Assessment (IGA). All 30 patients completed the trial. The mean baseline quantitative Goodman and Baron score was 13.2 ± 4.31, which improved to 5.37 ± 2.83 by the end of the study (P < 0.001). A significant improvement was also noted in the Goodman and Baron qualitative assessment of acne scars (P < 0.001). According to the PGA, the improvement rate was 25-50% in most patients (60%), while according to the IGA, the improvement rate was 25-49% in most patients (50%). Eleven patients (36.7%) were satisfied with the treatment process, while the other 19 patients (63.3%) were very satisfied. Side effects were minimal and transient. A single session of endo-radiofrequency subcision is a fairly safe and effective treatment, with a high satisfaction rate among treated patients.
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Acne Vulgar , Abrasão Química , Adolescente , Feminino , Humanos , Masculino , Acne Vulgar/complicações , Acne Vulgar/cirurgia , Abrasão Química/efeitos adversos , Cicatriz/etiologia , Cicatriz/cirurgia , Imunoglobulina A , Resultado do TratamentoRESUMO
INTRODUCTION: Coronavirus disease 2019 (COVID-19) mainly involves the respiratory system but can also affect the digestive system and cause several gastrointestinal manifestations. Acute pancreatitis has been reported as one of the rare presentations of COVID-19. This study aimed to systematically review case reports on COVID-19-associated acute pancreatitis. METHODS: Publications were retrieved through a comprehensive search in four databases on October 1, 2021. Eligible ones that demonstrated the potential association of acute pancreatitis and COVID-19 were included for data extraction. RESULTS: After screening 855 citations, 82 articles containing 95 cases were included, and their data were extracted. The most common presentation was abdominal pain (88/95, 92.6%), followed by nausea/vomiting (61/95, 64.2%). Mortality was reported in 10.5% of cases. The initial presentation was acute pancreatitis, COVID-19, and concomitant in 32.6% (31/95), 48.4% (46/95), and 18.9% (18/95) of cases, respectively. Among the included cases, acute pancreatitis severity was associated with ICU admission, COVID-19 severity, and the outcome. Also, the initial presentation was associated with COVID-19 severity (P values Ë0.05). CONCLUSIONS: Current evidence indicates that acute pancreatitis can present before, after, or concomitant with COVID-19. Appropriate investigations should be performed in cases with suspicious clinical presentations. Longitudinal studies should address whether or not, there is a causative relationship between COVID-19 and acute pancreatitis.
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COVID-19 , Pancreatite , Humanos , COVID-19/complicações , SARS-CoV-2 , Doença Aguda , Pancreatite/etiologia , PolôniaRESUMO
Background: Bariatric surgery is an appropriate treatment for obese patients with metabolic syndrome. Adipose tissue is an active endocrine tissue secreting leptin and adiponectin that affect body metabolism. Nowadays, a high incidence of metabolic syndrome with an increased risk of serious diseases has been detected in Shiraz. This study aimed to assess the levels of leptin and adiponectin as well as the adiponectin-to-leptin ratio in three different bariatric surgeries among obese patients in Shiraz. The results will play an important role in physicians' choice of surgery by distinguishing the effects of these three bariatric surgeries. Materials and Methods: The serum adiponectin and leptin levels were measured using enzyme-linked immunosorbent assay. Blood glucose, lipid profile, weight, and liver enzyme level were measured before and 7 months after surgery. Results: This clinical trial was conducted on 81 obese patients who underwent sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and single anastomosis sleeve ileal (SASI) bypass surgeries. The results revealed a decrease in fasting blood sugar and triglyceride (TG) levels 7 months after the surgeries. In addition, decrease of body mass index (BMI) was more significantly in the SASI group (12.8 ± 3 4.95) compared to the Roux-en-Y gastric group (8.56 ± 4.61) (P = 0.026). Besides, a more significant improvement in liver function was observed in SG (P < 0.05). Furthermore, the results revealed a significant difference among the three groups regarding the increase in the adiponectin level (P = 0.039). Decrease in the leptin level and increase in the adiponectin level were more significant after the RYGB surgery compared to the SG group (P < 0.05). Conclusion: The three bariatric surgeries were effective in increasing the adiponectin level and decreasing the leptin levels. The surgeries also changed the metabolic risk factors including TGs, high-density lipoprotein, fasting blood glucose, and BMI.
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Knowledge of living donor liver transplantation (LDLT) for autoimmune liver diseases (AILDs) is scarce. This study analyzed survival in LDLT recipients registered in the European Liver Transplant Registry with autoimmune hepatitis, primary biliary cholangitis, primary sclerosing cholangitis (PSC) and the non-autoimmune disorder alcohol-related cirrhosis. In total, 29 902 individuals enrolled between 1998 and 2017 were analyzed, including 1003 with LDLT. Survival from >90 days after LDLT for AILDs in adults was 85.5%, 74.2%, and 58.0% after 5, 10, and 15 years. Adjusted for recipient age, sex, and liver transplantation era, adult PSC patients receiving LDLT showed increased mortality compared to donation after brain death (DBD) (hazard ratio [HR] = 1.95, 95% confidence interval [CI] = 1.36-2.80, p < .001). Pediatric PSC patients showed also increased mortality >90 days after LDLT compared to DBD (HR = 3.00, 95% CI 1.04-8.70, p = .043). Multivariate analysis identified several risk factors for death in adult PSC patients receiving LDLT including a male donor (HR = 2.49, p = .025). Adult PSC patients with LDLT versus DBD conferred increased mortality from disease recurrence (subdistribution hazard ratio [subHR] = 5.36, p = .001) and biliary complications (subHR = 4.40, p = .006) in multivariate analysis. While long-term outcome following LDLT for AILD is generally favorable, PSC patients with LDLT compared to DBD might be at increased risk of death.
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Hepatopatias , Transplante de Fígado , Adulto , Morte Encefálica , Criança , Sobrevivência de Enxerto , Humanos , Hepatopatias/etiologia , Transplante de Fígado/efeitos adversos , Doadores Vivos , Masculino , Sistema de Registros , Estudos Retrospectivos , Resultado do TratamentoRESUMO
BACKGROUND: Natural nutrition and physical training have been defined as non-pharmacochemical complementary and alternative medicines to prevent and treat various pathogenesis. Royal jelly possesses various pharmacological properties and is an effective therapeutic supplement for halting neurodegeneration. Multiple sclerosis is a prevalent neurodegenerative disorder that manifests as a progressive neurological condition. Inflammation, hypoxia, and oxidative stress have been identified as significant hallmarks of multiple sclerosis pathology. RESULTS: In the present study, based on artificial intelligence and bioinformatics algorithms, we marked hub genes, molecular signaling pathways, and molecular regulators such as non-coding RNAs involved in multiple sclerosis. Also, microRNAs as regulators can affect gene expression in many processes. Numerous pathomechanisms, including immunodeficiency, hypoxia, oxidative stress, neuroinflammation, and mitochondrial dysfunction, can play a significant role in the MSc pathogenesis that results in demyelination. Furthermore, we computed the binding affinity of bioactive compounds presented in Royal Jelly on macromolecules surfaces. Also, we predicted the alignment score of bioactive compounds over the pharmacophore model of candidate protein as a novel therapeutic approach. Based on the q-RT-PCR analysis, the expression of the Dnajb1/Dnajb1/Foxp1/Tnfsf14 and Hspa4 networks as well as miR-34a-5p and miR155-3p were regulated by the interaction of exercise training and 100 mg/kg Royal Jelly (ET-100RJ). Interestingly, characteristics, motor function, a proinflammatory cytokine, and demyelination were ameliorated by ET-100RJ. DISCUSSION: Here, we indicated that interaction between exercise training and 100 mg/kg Royal jelly had a more effect on regulating the microRNA profiles and hub genes in rats with Multiple sclerosis.
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MicroRNAs , Esclerose Múltipla , Animais , Inteligência Artificial , Biologia Computacional , Ácidos Graxos/química , Ácidos Graxos/farmacologia , Ácidos Graxos/uso terapêutico , Fatores de Transcrição Forkhead , Hipóxia/tratamento farmacológico , MicroRNAs/genética , Ratos , Proteínas RepressorasRESUMO
OBJECTIVE: We aimed to inquire whether any seizure rescue medications are included in the in-flight medical emergency kits of the main airlines in the world. This data could help the airline authorities update their strategies in light of any shortcomings. METHODS: First, we identified ten major airlines in the world. Then, we searched the Google engine with the following keywords: "name of the airline" and "in-flight medical emergency" or "first aid kit" or "emergency kit". In case there was no information on the web, we emailed the airlines and inquired about the contents of their in-flight medical emergency kits. We also investigated some of the major aviation organizations' websites [i.e., Aerospace Medical Association (AsMA), International Civil Aviation Organization (ICAO), and International Air Transport Association (IATA)]. RESULTS: None of the major airlines were equipped with easily applicable seizure rescue medications (i.e., buccal midazolam, a nasal spray of midazolam, or intranasal diazepam). The AsMA and ICAO recommend including injectable sedative anticonvulsant drugs in the in-flight medical emergency kits without any further specifications. The IATA does not provide specific recommendations for including seizure rescue medications in the in-flight medical emergency kits. CONCLUSION: A seizure is a significant in-flight medical emergency event. The use of easily applicable seizure rescue medications during prolonged or repeated seizures is significantly associated with fewer sequelae for the affected person. Easily applicable seizure rescue medications should be included in the in-flight medical emergency kits, and the cabin crew should receive training on how and when to use them.
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Medicina Aeroespacial , Humanos , Midazolam , Primeiros Socorros , Diazepam , Convulsões/tratamento farmacológicoRESUMO
Pruritus is a symptom that adversely affects the quality of life of patients with epidermolysis bullosa (EB). Although studies indicate the positive effect of gabapentin on some types of pruritus, its effect on pruritus due to EB remains unexplored. Hence, this study investigated the efficacy of topical gabapentin in treating EB pruritus. We piloted a 6-week, double-blind, split-site, randomized controlled trial on 14 patients with EB pruritus. In each patient, one pruritic lesion received topical gabapentin and the other a placebo. The items of the Leuven Itch Scale were evaluated before and after therapy; the lesions were photographed, and their appearance (i.e., erythema and excoriation severity, pruritic geometric area) was objectively assessed. Statistical analyses were made using SPSS v. 25. Quantitative data were reported as median (interquartile range) or mean ± standard deviation as appropriate. The median age of the 14 patients was 18 years (12-37), and the majority (64.3%) were male. A significant improvement was seen in the geometric area of the pruritic lesion in the intervention group (p = 0.005) but not in the control group (p = 0.054). Erythema severity, excoriation intensity, pruritus frequency and duration, and symptom-related distress significantly improved in both groups (p < 0.05 in all cases), but topical gabapentin failed to offer any statistical superiority relative to the placebo in the between-group analysis (p > 0.05). This study showed no significant difference between topical gabapentin and placebo in erythema severity, excoriation intensity, pruritus frequency and duration, and symptom-related distress among EB patients. However, the lesion area decreased only in the gabapentin group.
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Epidermólise Bolhosa , Qualidade de Vida , Adolescente , Adulto , Criança , Método Duplo-Cego , Epidermólise Bolhosa/complicações , Epidermólise Bolhosa/diagnóstico , Feminino , Gabapentina/uso terapêutico , Humanos , Masculino , Prurido/diagnóstico , Prurido/tratamento farmacológico , Prurido/etiologia , Adulto JovemRESUMO
Brimonidine is a vasoconstrictive agent used to treat several dermatologic disorders. Here, we review the uses of brimonidine in different aspects of dermatology. We searched keywords including rosacea, erythema, topical brimonidine, dermatology, and skin disease in PubMed, Cochrane, and Google Scholar to collect the related published articles. In a review of 15 articles, we found topical brimonidine improved the facial erythema of rosacea. In addition, it reduced the erythema associated with alcohol flushing syndrome, intense pulsed light therapy, and photodynamic therapy. Furthermore, topical brimonidine was used as a hemostatic agent in dermatosurgery procedures such as Mohs surgery and nail surgery to reduce intra-operative and postoperative bleeding. Some side effects such as erythema, flushing, and burning were reported in a few patients. Based on our findings, brimonidine is a beneficial drug that can be used in various dermatologic disorders with negligible side effects.
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Dermatologia , Rosácea , Humanos , Tartarato de Brimonidina/efeitos adversos , Resultado do Tratamento , Rosácea/tratamento farmacológico , Eritema/tratamento farmacológicoRESUMO
BACKGROUND: Despite the widespread knowledge about social support and health, there is little information about the association between social support and HIV risk behaviors such as condom use among female sex workers (FSWs) in Iran. This study aimed to determine the association between social support and frequency of condom use among FSWs in Tehran, Iran. METHODS: Using mixed sampling methods, we recruited 170 FSWs in Tehran in 2017. We measured self-reported social support by face-to-face interviews using a standardized questionnaire. Linear regression was used to assess the association between socio-demographic characteristics (age, education level, marital status, and place of living), transactional sex characteristics (age at first transactional sex and frequency of transactional sex in the last month), HIV knowledge, social support network characteristics (social network size, duration of tie, intimacy, social support), and condom use behavior. RESULTS: Of the total of 1193 persons in FSW's social networks, 615 (51%) were sexual partners, 529 (44%) were peer sex workers, and 36 (5%) were family members. The participants perceived moderate social support from sexual partners, low from peer sex workers, and very low from family members. Adjusted for individual and other network characteristics, peer sex worker social support (b = 0.28, 95%CI 0.06, 0.50), and family support (b = 1.12, 95%CI 0.028, 2.23) were significantly associated with condom use. CONCLUSION: Family and peer sex worker social support are associated with condom use, but less strongly than HIV knowledge or place of living. However, very few FSWs are socially connected with families. Interventions to promote condom use among this vulnerable population should also consider social and familial support.
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Infecções por HIV , Profissionais do Sexo , Preservativos , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Humanos , Irã (Geográfico) , Comportamento Sexual , Parceiros Sexuais , Apoio SocialRESUMO
This study was conducted to determine the exposure rate of Hepatitis A and Hepatitis E viruses in urban solid waste collectors/sweepers in the south of Iran. The 385 samples (serums) were collected from Shiraz Municipality waste sweepers.. A questionnaire was used to gather data on their demographic and occupational characteristics, as well as their awareness of viral hepatitis disease. The viral seroprevalence was determined by commercial IgG ELISA kit. All participants were male, mean age of 41 ± 8 years. ELISA assay showed that all of them were positive for anti-HAV IgG. Also, 62 out of 385 individuals were positive for anti-HEV IgG. The statistical analysis showed that the frequency of HEV IgG antibody among age groups 20-30, 31-40, 41-50 and >50 years old had an increasing trend, 4.5%, 10.1%, 17.4%, and 36.7%, respectively, indicating age factor significance (p = .001). Based on some investigated factors including the duration of work experience, current and previous jobs, habitation, personal hygiene status, and knowledge on viral hepatitis diseasees/their transmission, there was no statistically significant difference between anti-HEV IgG positive versus negative sweepers. The results indicated a slighty higher frequency of anti-HAV and anti-HEV IgG among sweepers compared to other pre-investigated population. It doesn't seem that garbage collecting/sweeping could be a significant risk factor for HAV and HEV infection.
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Vírus da Hepatite A , Hepatite A , Vírus da Hepatite E , Hepatite E , Adulto , Estudos Transversais , Feminino , Hepatite A/epidemiologia , Anticorpos Anti-Hepatite A , Hepatite E/epidemiologia , Humanos , Imunoglobulina G , Imunoglobulina M , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos SoroepidemiológicosRESUMO
Elderly is a part of life that is associated with physical and mental disorders. The present study aimed to investigate the effect of 8 weeks of high-intensity interval training (HIIT) along with genistein (Ge) on memory, anxiety, physical persistence and aerobic power in elderly rats. Forty elderly rats were randomly assigned to five groups of eight rats including 1) control (C), 2) sham (Sh), 3) HIIT, 4) HIIT+Ge, and 5)Ge. During 8-week groups 3 and 4 performed HIIT for three sessions per week and groups 4 and 5 received 60 mg/kg/day Ge peritoneally. Physical persistence (by forced swimming test), memory (by shuttle box and Y maze tests), anxiety (by elevated plus-maze test) and aerobic power (by exhaustive running on treadmill) were measured. HIIT, Ge, and HIIT+Ge significantly increased physical persistence and memory (P ≤0.05), HIIT and HIIT+Ge significantly decrease anxiety and increased aerobic power (P ≤0.05) and HIIT+Ge had higher effect on the decrease of anxiety and increase of memory compared to HIIT and Ge (P≤0.05). Although HIIT and Ge alone can enhance physical persistence, memory and anxiety in elderly rats nevertheless it seems that HIIT simultaneously with Ge has more favorable mental health benefits compared to HIIT and Ge alone.
Assuntos
Genisteína , Treinamento Intervalado de Alta Intensidade , Idoso , Envelhecimento , Animais , Teste de Esforço , Genisteína/farmacologia , Humanos , Saúde Mental , RatosRESUMO
This paper reports a coherent method for ranking fruit juice products in the Iranian food industry by the best-worst method by examining the factors affecting product quality. To achieve the aim, a combination of laboratory methods and mathematical calculations was used. The statistical population in this study included samples of products of several food companies (SH, S, P) in Iran. Some factors affecting the quality of fruit juice products including alcohol, sugar, degrees Brix, and pH were considered and several samples of apple and grape juice from different brands were prepared and analyzed. In the first stage, to determine the value of the parameters of each sample was determined by the standard analysis methods. Then, the best-worst method was applied to measure the selection criteria of juice producers, and then the function of linear values of the piece was used to rank the Juice products of the studied companies (SH, S, P). The results showed the following order for the studied brands: P-Apple > S-Grape > SH-Apple > SH-Grape > S-Apple. This study showed that the multi-criteria decision theory is a promising method to rank food products of different companies.
RESUMO
BACKGROUND: Genetic abnormalities might have important role in pathogenesis of hepatic steatosis after liver transplantation. We aimed to investigate association between genetic variations in transmembrane 6 superfamily member 2 (TM6SF2) rs58542926, proprotein convertase subtilisin/kexin type 9 (PCSK9) rs505151 and proprotein convertase subtilisin/kexin type 7 (PCSK7) rs2277287 with hepatic steatosis in liver transplant recipients. METHODS: In a cross-sectional study, adult (> 18 years) liver transplant recipients who were referred for their routine post-transplant follow-up between June 2018 and September 2018 were included in the study. Hepatic steatosis in transplant recipients was assessed by controlled attenuation parameter (CAP). Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to study TM6SF2 rs58542926, PCSK7 rs2277287 and PCSK9 rs505151 genotypes. RESULTS: 107 liver transplant recipients were included. There was no association between different genotypes of PCSK9 rs505151 and PCSK7 rs2277287 with hepatic steatosis in liver transplant recipients (P value > 0.05). The presence of TT genotype of TM6SF2 rs58542926 was higher in patients with hepatic steatosis measured by CAP after liver transplantation. In patients with moderate and severe hepatic steatosis (grade 2 and 3 steatosis), AG + GG genotypes of PCSK9 rs505151 were more prevalent than AA genotype (OR 8.667; 95% CI 1.841-40.879; P value = 0.004) compared to patients with mild steatosis (grade 1). In multivariate regression model, AG + GG genotypes of PCSK9 rs505151 were associated with moderate and severe steatosis in liver transplant recipients (OR 5.747; 95% CI 1.086-30.303; P value = 0.040). CONCLUSIONS: Genetic variations in TM6SF2 rs58542926 and PCSK9 rs505151 might be associated with hepatic steatosis in liver transplant recipients.