Rational design of an anti-cancer peptide inhibiting CD147 / Cyp A interaction.

The CD147 / Cyp A interaction is a critical pathway in cancer types and an essential factor in entering the COVID-19 virus into the host cell. Melittin acts as an inhibitory peptide in cancer types by blocking the CD147/ Cyp A interaction. The clinical application of Melittin is limited due to weak penetration into cancer cells. TAT is an arginine-rich peptide with high penetration ability into cells widely used in drug delivery systems. This study aimed to design a hybrid peptide derived from Melittin and TAT to inhibit CD147 /Cyp A interaction. An amino acid region with high anti-cancer activity in Melittin was selected based on the physicochemical properties. Based on the results, a truncated Melittin peptide with 15 amino acids by the GGGS linker was fused to a TAT peptide (nine amino acids) to increase the penetration rate into the cell. A new hybrid peptide analog(TM) was selected by replacing the glycine with serine based on random point mutation. Docking results indicated that the TM peptide acts as an inhibitory peptide with high binding energy when interacting with CD147 and the CypA proteins. RMSD and RMSF results confirmed the high stability of the TM peptide in interaction with CD147. Also, the coarse-grained simulation showed the penetration potential of TM peptide into the DOPS-DOPC model membrane. Our findings indicated that the designed multifunctional peptide could be an attractive therapeutic candidate to halter tumor types and COVID-19 infection.

Concurrent anorectal and cervical cytology in women with positive and negative cervical smear test results: A cross-sectional study.

OBJECTIVE: Considering the exponentially growing concerns about the increase of anal cancer rates in women with human papillomavirus (HPV) infection and cervical intraepithelial neoplasia, the authors evaluated concurrent anorectal and cervical cytology in women with positive and negative cervical smear tests. METHOD: The current investigation was designed as a cross-sectional study conducted in Arash Women's Hospital, Tehran, Iran, between November 2020 and November 2021. Cervical cytology, HPV test, and anal cytology samples were prepared. Then women with abnormal cervical cytology and/or positive high-risk HPV were referred to a colposcopy clinic for further evaluation. RESULTS: Five hundred and forty-three women were recruited during the study period. These women were divided into two groups of positive cervical cytology (n = 161) and negative cervical cytology (n = 382). There were no cases of anal intraepithelial neoplasia in either group. Negative anal cytology was reported in 99 (61.5%) of participants with a positive cervical cytology and 254 (66.7%) of participants with a negative cervical cytology. A total of 62 (38.5%) anal samples in the positive group and 127 (33.3%) in the negative group were unsatisfactory for further evaluation. CONCLUSION: We were unable to show any correlation between abnormal cervical cytology, dysplasia, or cervical high-risk HPV with anal abnormal cytology.

An Evaluation of the Association between Quality of Life and Psychological Issues in Patients with Automated Implantable Cardioverter Defibrillator.

Introduction: Implantable cardioverter defibrillator (ICD) plays a life-saving role via controlling malignant dysrhythmias. However, it may result in the incidence of psychological tensions in patients' lives, eventually leading to changes in their quality of life (QoL). To date, this association has remained unclear among Iranian population. Therefore, the present study aimed to determine the association between QoL and psychological issues in patients with ICD. Methods: Using convenience sampling method, this cross-sectional study was conducted on 96 patients referred to the pacemaker clinic of Shahid Faghihi hospital and Kowsar heart hospital affiliated to Shiraz University of Medical Sciences, Iran from September 2016 to January 2017. The data were collected using Depression, Anxiety, Stress Scale (DASS-21) and the Short Form-36 (SF-36) questionnaire, and analyzed in SPSS software version 13 using independent t-test, Pearson's correlation test, and ANOVA. Results: The mean (SD) score of patients' QoL was found to be 1672.02 (43.43). Moreover, the mean (SD) scores of depression, anxiety, and stress were 4.69 (0.46), 5.6 (0.47), and 7.51 (0.05), respectively indicating moderate depression, anxiety, and stress levels among the patients. A significant association was found between the patients' QoL and depression, anxiety, and stress. Conclusion: As an association was observed between the patients' QoL and depression, anxiety, and stress, performing some interventions to reduce the patients' psychological issues might improve their QoL.

Assessment of the Relationship between Nurses' Perception of Ethical Climate and Job Burnout in Intensive Care Units

Objective. To determine the relationship between ethical climate and burnout in nurses working in Intensive Care Units (ICUs). Methods. This cross-sectional and multi-center study was conducted among 212 nurses working in adult ICUs of six hospitals affiliated to Shiraz University of Medical Sciences, Iran in 2019. The participants were selected using systematic random sampling technique. Data was collected using valid instruments of Olson's Hospital Ethical Climate Survey (HECS) and Maslach Burnout Inventory (MBI). Results. Ethical climate was favorable (3.5±0.6). The intensity (32.2±12.4) and frequency (25.5±12.4) of burnout were high. Ethical climate had significant and inverse relationships with frequency of burnout (r =-0.23, p=0.001) and with intensity of burnout (r=-0.186, p=0.007). Ethical climate explained 5.9% of burnout. Statistically significant relationships were also found between these factors: age with ethical climate (p=0.001), work shifts with burnout (p=0.02), and gender and with intensity frequency of burnout in ICU nurses (p=0.038). The results of Spearman correlation coefficient showed significant and inverse relationships between ethical climate and job burnout (r=-0.243, p<0.001). Conclusion. Nurses in ICUs perceived that ethical climate was favorable however, burnout was high. Therefore, burnout can be affected by many factors and it is necessary to support ICU nurses since they undertake difficult and complicated task. It is recommended to assess factors that increase burnout and adopt specific measures and approaches to relieve nursing burnout.

Objetivo. Determinar la percepción de las enfermeras sobre el clima ético y el agotamiento laboral en las Unidades de Cuidados Intensivos (UCI). Métodos. Este estudio de corte transversal y multicéntrico se realizó con 212 enfermeros que trabajaban en UCI para adultos de seis hospitales afiliados a la Universidad de Ciencias Médicas de Shiraz, Irán, en 2019. Los participantes se seleccionaron mediante una técnica de muestreo aleatorio sistemático. Los datos se recolectaron a partir de la utilización de instrumentos Encuesta de Clima Ético en Hospitales (HECS) de Olson y el Inventario de Burnout de Maslach (MBI). Resultados. El clima ético fue favorable (3.5±0.6). La intensidad (32.2±12,4) y la frecuencia (25.5±12.4) del agotamiento fueron altas. El clima ético tuvo relaciones significativas e inversas con la frecuencia de Burnout (r=-0.23, p=0.001) y con la intensidad del burnout (r=-0.186, p=0.007). El clima ético explica el 5.9% del agotamiento. También se encontraron relaciones estadísticamente significativas entre edad y clima ético (p=0.001), turnos de trabajo y burnout (p=0.02), además de género y frecuencia de intensidad de burnout (p=0.038). El coeficiente de correlación de Spearman mostró relaciones significativas e inversas entre el clima ético y el agotamiento laboral (r=-0.243, p<0.001). Conclusión. Las enfermeras en las UCI percibieron que el clima ético era favorable, sin embargo, el desgaste fue alto. Por tanto, el burnout puede verse influido por muchos factores y es necesario apoyar a estas enfermeras que cumplen una tarea difícil y complicada. Se recomienda evaluar los factores que aumentan el agotamiento y adoptar medidas y enfoques específicos para aliviar el burnout de enfermería.

Objetivo. Verificar a diferença entre a percepção dos enfermeiros sobre o clima ético e o desgaste no trabalho em Unidade de Terapia Intensiva (UTI). Métodos. Este estudo transversal e multicêntrico foi realizado com 212 enfermeiras que trabalham na UTI adulto de seis hospitais afiliados à Universidade de Ciências Médicas de Shiraz, Irão, em 2019. Os participantes foram selecionados por meio de uma técnica de amostragem aleatória sistemática. Os dados foram coletados usando os instrumentos Enquete de Clima Ético em Hospitais (HECS) de Olson e o Inventário Burnout de Maslach (MBI). Resultados. O clima ético era favorável (3.5±0.6). A intensidade (32.2±12.4) e a frequência (25.5±12.4) de exaustão foram altas. O clima ético teve relações significativas e inversas com a frequência de Burnout (r=-0.23, p=0.001) e com a intensidade de Burnout (r=-0.186, p=03007). O clima ético explica 5,9% do esgotamento. Também foram encontradas relações estatisticamente significativas entre: idade e clima ético (p=0.001), turnos de trabalho e Burnout (p=0,02), além de gênero e frequência da intensidade do Burnout (p=0.038). O coeficiente de correlação de Spearman mostrou relações significativas e inversas entre clima ético e Burnout (r=-0243, p<0.001). Conclusão. As enfermeiras das UTIs perceberam que o clima ético era favorável, porém, o desgaste foi alto. Portanto, o Burnout pode ser influenciado por diversos fatores e é necessário apoiar essas enfermeiras que cumprem uma tarefa difícil e complicada. Recomenda-se avaliar os fatores que aumentam o Burnout e adotar medidas e abordagens específicas para aliviar o Burnout da enfermagem.

Effect of yoga exercise on the quality of life and upper extremity volume among women with breast cancer related lymphedema: A pilot study.

PURPOSE: This pilot study aimed to evaluate the effect of an 8-weeks-yoga intervention on quality of life and upper extremity edema volume in women with breast cancer related lymphedema. METHODS: This was a controlled trial with pre-post design. A total of 40 women with breast cancer related lymphedema were randomly assigned into an intervention or control groups. The intervention group participated in a yoga exercise class for 8 weeks, in a twice a week instructor-led practice and once a week home practice. Outcomes were EORTC QLQ_C30 to measure quality of life, and water displacement volume-meter to measure upper extremity edema volume. The outcomes were evaluated at baseline, 4th and 8th week. Data were analyzed using SPSS. RESULTS: Four weeks after the intervention, a significant difference was observed between the groups with respect to role functioning of quality of life (P = 0.03). Eight weeks after the intervention, a significant difference was observed between groups concerning physical and emotional functioning of quality of life (P < 0.05). The changing trend in physical, role, emotional, and cognitive functioning had increased, and in some scales such as fatigue, pain, insomnia, and financial difficulties the scores were reduced in the intervention group. Regarding edema volume, no significant difference was found between both groups on the 4th and 8th week after the intervention (P > 0.05). CONCLUSION: As yoga exercise might improve physical, role, and emotional functioning of quality of life as well as reduce fatigue, pain, and insomnia, using this intervention can be suggested amongst women with breast cancer related lymphedema.

The effects of oral rinse with 0.2% and 2% chlorhexidine on oropharyngeal colonization and ventilator associated pneumonia in adults' intensive care units.

BACKGROUND: Ventilator Associated Pneumonia (VAP) is the most common nosocomial infection in Intensive Care Units (ICUs) which increases the length of ICU stay, duration of mechanical ventilation, and mortality. The present study used an oral care protocol and compared the effects of two different concentrations of chlorhexidine on reduction of oropharyngeal colonization and VAP. MATERIALS AND METHODS: This study was performed on 114 patients from trauma, surgery, neurosurgery, and general ICUs randomly allocated to two groups under oral care with 0.2% and 2% chlorhexidine solution. A multidisciplinary team approved the oral care protocol. Data was collected using a demographic information form, APACHE IV form, Beck oral assessment scale, mucosal-plaque assessment scale, and oropharyngeal swab culture. RESULTS: The results showed a significant reduction in VAP (p=0.007) and oropharyngeal colonization (p=0.007) in the group under oral care with 2% chlorhexidine solution compared with the other group. However, no significant difference was found between the two groups in terms of oropharyngeal adverse effects (p=0.361). CONCLUSION: Oral decontamination with 2% compared to 0.2% chlorhexidine is a more effective method in the prevention of VAP and reduction of oropharyngeal colonization (especially gram-positive).

The Effect of Aloe Vera Solution on Chemotherapy-Induced Stomatitis in Clients with Lymphoma and Leukemia: A Randomized Controlled Clinical Trial.

BACKGROUND: Stomatitis is the most common complication of chemotherapy. This study aimed to assess the effect of aloe vera solution on stomatitis and its pain intensity in patients undergoing chemotherapeutic procedures. METHODS: In this randomized controlled clinical trial, 64 patients with Acute Myeloid Leukemia and Acute Lymphocytic Leukemia undergoing chemotherapy were randomly divided into a control and an intervention group. The intervention group patients were asked to wash their mouths with 5 ml of aloe vera solution for two minutes three times a day for 14 days. The control group patients, however, used only the ordinary mouthwashes recommended in hematologic centers. The patients' mouths were examined by two assistants on days 1, 3, 5, 7, and 14. The intensity of stomatitis was recorded according to WHO stomatitis intensity checklists and pain was evaluated using Visual Analog Scale. The data were analyzed by SPSS statistical software, version 18. RESULTS: The results showed that aloe vera solution mouthwash significantly reduced the intensity of stomatitis and its pain in the intervention group compared to the control group. On the first day, no significant difference was found between the two groups regarding the mean intensity of stomatitis (P=0.178) and pain (P=0.154). However, a significant difference was observed between the two groups in this regard on other days (days 3-14: P=0.001 for stomatitis intensity, P=0.001 for pain). CONCLUSIONS: Aloe vera solution can improve the patients' nutritional status, reduce stomatitis and its pain intensity, and increase the patients' satisfaction. Trial Registration Number IRCT2014092819318N1.