Promoting Psychosocial Health of Family Caregivers of Patients with Chronic Mental Disorders: A Review of Challenges and Strategies / 전남의대학술지

The present study aimed to investigate the mental and social health challenges of family caregivers of the patients with chronic mental disorders (CMD) and strategies which can be helpful in this regard. This study is a narrative review conducted in PubMed, Web of Science, Scopus, Elsevier, Google Scholar, Proquest, Magiran, and Sid databases where keywords such as Family caregiver, Chronic Mental disorder, Health Promotion, Program, Psychosocial, Support, Challenge, and Problem were searched in both Persian and English. A total of 5,745 published documents were found and were screened based on inclusion and exclusion criteria. Finally, 64 studies were found which had examined the related challenges, needs and strategies. According to the results, information deficits, needs for support, community participation deficits, and psychological suffering were recognized as challenges of family caregivers of these patients. Moreover, empowerments programs for the enhancement of the knowledge and skills of caregivers and peer-centered support programs were used to improve the level of mental and social health of family caregivers of these patients. Psychosocial problems and challenges that family caregivers of the patients with CMD face affect their health, satisfaction and quality of life. Using a collaborative approach, mental health service providers and government systems can help improve the psychosocial health of caregivers. The related managers and policymakers can reduce the emotional and psychological burden of families and promote their psychosocial health through developing a comprehensive program including practical objectives and strategies and taking into account the challenges that exist for caregivers in caring for patients with CMD.

Flaxseed can reduce hypoxia-induced damages in rat testes

Background: Hypoxia causes detrimental effects on the structure and function of tissues through increased production of reactive oxygen species that are generated during the re-oxygenation phase of intermittent and continuous hypobaric hypoxia. This study was carried out to evaluate the effects of flaxseed [Fx] in reducing the incidence of hypoxia in rat testes

Materials and Methods: In this experimental study, 24 adult Wistar rats were randomly divided into four groups: i. Control group [Co] that received normal levels of oxygen and food, ii. Sham group [Sh] that were placed in hypoxia chamber but received normal oxygen and food, iii. Hypoxia induction group [Hx] that were placed in hypoxia chamber and treated with normal food, iv. Hypoxia induction group [Hx+Fx] that were placed in hypoxia chamber and treated with 10% flaxseed food. Both the Hx and Hx+Fx groups were kept in a hypoxic chamber for 30 days; during this period rats were exposed to reduced pressure [oxygen 8% and nitrogen 92%] for 4 hours/day. Then, all animal were sacrificed and their testes were removed. Malondialdehyde [MDA] and total antioxidant capacity [TAC] levels were evaluated in the testis tissue. Tubular damages were examined using histological studies. Blood samples and sperm were collected to assess IL-18 level and measure sperms parameters, respectively. All data were analyzed using SPPSS-22 software. One way-ANOVA or Kruskal-Wallis tests were performed for statistical analysis

Results: A significant difference was recorded in the testicular mass/body weight ratio in Hx and Hx+Fx groups in comparison to the control [P=0.003 and 0.027, respectively] and Sh [P=0.001 and 0.009, respectively] groups. The sperm count and motility in Hx+Fx group were significantly different from those of the Hx group [P=0.0001 and 0.028, respectively]. Also sperm viability [P=0.0001] and abnormality [P=0.0001] in Hx+Fx group were significantly different from Hx group

Conclusion: This study therefore suggests that the oral administration of flaxseed can be useful for prevention from the detrimental effects of hypoxia on rat testes structure and sperm parameters

Assessing the diagnostic value of plasma-Free DNA in prostate cancer screening

Background: Prostate cancer is the second form of cancer among men worldwide. For early cancer detection, we should identify tumors in initial stages before the physical signs become visible. The present study aims to evaluate the diagnostic value of cell-free DNA [cfDNA], its comparison with prostate-specific antigen [PSA] level in prostate cancer screening and also in patients with localized prostate cancer, metastatic form, and benign prostatic hyperplasia [BPH]

Methods: The participants of this study were selected from 126 patients with genitourinary symptoms suspected prostate cancer, rising PSA, and/or abnormal rectal examination results and 10 healthy subjects as controls. Peripheral blood plasma before any treatment measures was considered. cfDNA was extracted using a commercial kit, and PSA levels were measured by ELISA. The ANOVA test was used to compare the average serum level of PSA and plasma concentration of cfDNA between the groups. The correlation between variables was measured by the Pearson test

Results: The subgroups consisted of 50 patients with localized prostate cancer, 26 patients with metastatic prostate cancer, 50 patients with BPH, and 10 healthy subjects; the average concentrations of cfDNA in these subgroups were 15.04, 19.62, 9.51, and 8.7 ng/Mul, respectively. According to p < 0.0001 obtained from multivariate test, there was a significant difference between all the groups

Conclusion: Our findings indicated significant differences between cfDNA levels of patients with localized and metastatic prostate cancer, and differences of these two groups from BPH and healthy cases show the importance of this biomarker in non-invasive diagnostic procedures

Probiotics and their role in gastrointestinal cancers prevention and treatment; an overview

Cancers of the gastrointestinal [GI] track are a serious global health problem. The human GI tract is home to trillions of microorganisms that known as gut microbiota and have established a symbiotic relationship with the host. The human intestinal microbiota plays an important role in the development of the gut immune system, metabolism, nutrition absorption, production of short-chain fatty acids and essential vitamins, resistance to pathogenic microorganisms, and modulates a normal immunological response. Microbiota imbalance has been involved in many disorders including inflammatory bowel disease, obesity, asthma, psychiatric illnesses, and cancers. Oral administration of probiotics seems to play a protective role against cancer development as a kind of functional foods. Moreover, clinical application of probiotics has shown that some probiotic strains can reduce the incidence of post-operative inflammation in cancer patients. In the present narrative review, we carried out update knowledge on probiotic effects and underlying mechanism to GI cancers. Currently, it is accept that most commercial probiotic products are generally safe and can used as a supplement for cancer prevention and treatment. Nevertheless, well-designed, randomized, double blind, placebocontrolled human studies are required to gain the acceptance of the potential probiotics as an alternative therapy for cancer control.

[Cassette chromosome mec typing of methicillin-resistant staphylococcus aureus isolates collected from Sina and Imam Reza Hospitals of Tabriz]

Backgrounds and Objectives: Methicillin-resistant Staphylococcus aureus is a cause of nosocomial infections leading to high mortality. Since these strains have become prevalent in the world, it is necessary to identify and type them

Materials and Methods: This cross-sectional study was conducted to study a total of 1475 specimens collected from patients of Imam Reza and Sina hospitals of Tabriz in 2012-2013. Using phenotypic tests such as Gram stain, catalase, coagulase, DNase and mannitol fermentation 169 isolates of Staphylococcus aureus and by utilizing methicillin-resistance test 100 MRSA isolates were identified. SCCmec typing was performed by multiplex PCR method and the results were analyzed using chi-square tests using SPSS-18 software

Results: Disc agar diffusion test using cefoxitin disc [30 microg] showed methicillin resistance in 59% of our isolates. mecA and femB genes were identified in all of the MRSA isolates using PCR method. Frequency of SCCmec types and sub-types were as follow: SCCmecIII [77%], SCCmecI [5%], SCCmecIVa [1%], SCCmecIVc [1%], mixed isolates SCCmecIVc-III [1%] and Non typeable isolates [15%]. Non typeable isolates recovered in two groups [10% without any band and 5% of multi-bands III-I]. In this study, 82% of isolates were HA-MRSA, 3% were CA-MRSA and 15% were Non-typeable

Conclusion: In our S. aureus isolates, the prevalence of methicillin resistance was 59%. The most frequent SCCmec type was SCCmecIII [77%]. Our results demonstrated the spread of HA-MRSA isolates in the community and propagating CA-MRSA isolates in the studied hospitals

Role of somatic testicular cells during mouse spermatogenesis in three-dimensional collagen gel culture system

Spermatogonial stem cells [SSCs] are the only cell type that can restore fertility to an infertile recipient following transplantation. Much effort has been made to develop a protocol for differentiating isolated SSCs in vitro. Recently, three-dimensional [3D] culture system has been introduced as an appropriate microenvironment for clonal expansion and differentiation of SSCs. This system provides structural support and multiple options for several manipulation such as addition of different cells. Somatic cells have a critical role in stimulating spermatogenesis. They provide complex cell to cell interaction, transport proteins and produce enzymes and regulatory factors. This study aimed to optimize the culture condition by adding somatic testicular cells to the collagen gel culture system in order to induce spermatogenesis progression. In this experimental study, the disassociation of SSCs was performed by using a two-step enzymatic digestion of type I collagenase, hyaluronidase and DNase. Somatic testicular cells including Sertoli cells and peritubular cells were obtained after the second digestion. SSCs were isolated by Magnetic Activated Cell Sorting [MACS] using GDNF family receptor alpha-1 [Gfr Alpha -1] antibody. Two experimental designs were investigated. 1. Gfr Alpha -1 positive SSCs were cultured in a collagen solution. 2. Somatic testicular cells were added to the Gfr Alpha -1 positive SSCs in a collagen solution. Spermatogenesis progression was determined after three weeks by staining of synaptonemal complex protein 3 [SCP3]-positive cells. Semi-quantitative Reverse Transcription PCR was undertaken for SCP3 as a meiotic marker and, Crem and Thyroid transcription factor-1 [TTF1] as post meiotic markers. For statistical analysis student t test was performed Testicular supporter cells increased the expression of meiotic and post meiotic markers and had a positive effect on extensive colony formation. Collagen gel culture system supported by somatic testicular cells provides a microenvironment that mimics seminiferous epithelium and induces spermatogenesis in vitro

Juvenile hemochromatosis, genetic study and long-term follow up after therapy

BACKGROUND: Hereditary hernochrornatosis [HH] is a very rare disease in Iran and reported cases are all negative for HFE mutation. We report a family affected by severe juvenile hernochrornatosis [JH] with a detailed molecular study of the family members

METHODS: We studied a pedigree with siblings affected by juvenile HH and followed them for 3 years. Microsatellite and gene sequencing analysis was performed for all family members

RESULTS: Two siblings [the proband and his sister, aged 26 and 30 years, respectively] were found to have clinical findings of JH. The proband's brother, who presented with hyperpigmentation, died of probable JH at the age of 24 years. Gene sequencing analysis showed that the proband has a homozygote c.265T>C [p.C89R] HJV mutation + a heterozygote c.884T>C [p.V295A] mutation of HFE

The affected proband's sister presented with the same HJV c.265T>C [p.C89R] homozygote mutation. In addition, we found the HJV C.98-6OG polymorphic variant in both the sister and proband [homozygote]

Sequencing of hepcidin [HAMP], TfR2, and FPN revealed no mutation

CONCLUSION: We have shown that molecular analysis of the HH related gene is a powerful tool for reliable diagnosis of JH and, in conjunction with magnetic resonance imaging [MRI] and noninvasive liver stiffness measurement by elastography, is adequate tool for management and follow up of HH

Valproate effects on chemophysical properties of human serum albumin

Albumin has a fundamental role in human body. Its main tasks in blood are to regulate osmotic blood pressure, maintaining the pH, and transporting metabolites and drugs throughout the vascular system. Pharmacological studies of the interaction of drugs on HSA are important due to structural and functional changes of this vital protein; thus, here in this research the effect of valproate as a common drug for epilepsy disorders is evaluated in the presence of hexadecyl pyridinium bromide [HPB] as a positive surfactant in normal and fever condition. Electrochemical method was used to investigate the binding number of HPB molecules to HSA in the absence and presence of valproate by evaluating the concentration of free HPB in 37 C and 42 C temperatures. HSA affinity for valproate binding studied via ligand binding process for normal and fever temperatures. The findings indicate that, there is a significant difference in valproate binding to albumin at physiological and pathological temperatures. The consequences are the same in the presence of HPB; in other words, HSA binding tendency to HPB in the presence of valproate was totally altered because of HSA major conformational changes in fever condition. In conclusion, corrected dosage of valproate is needed for fever condition relative to normal temperature and the patients under prescription of different medications in fever condition should have different orders due to the interferences of drugs

concentration of serum selenium in multiple sclerosis patients compare to healthy subject in Tehran

Multiple sclerosis [MS] is an inflammatory demyelinating disease which the exact etiology is still are far to be clear. Reasons for this autoimmune disease are unknown origin. The aim of present study was to evaluate serum levels of selenium in patient with MS compare to healthy subjects. A total of 46 subjects were enrolled in the study, Sera of 23 MS cases and 23 healthy normal cohorts as control group were obtained. Atomic absorption spectrophotometer was employed for estimating serum selenium level. Serum. selenium levels were significantly lower in MS than in control cohorts [60.87+/-13 compared with 85.74+/-12, P-value < 0.0001]. Serum selenium levels may thus be a marker of MS; the decreasing levels of serum selenium may be host defense strategies of body

Comparative study of serum levels of granzyme H and estrogen in patients suffering from breast cancer

GranymeH is a functional cytotoxic serine protease of NK cell granules,which expands the cell death-inducing repertoire of innate immune system.The purpose of this study was to determine GranymeH[GZMH]level in breast cancer[BC] and healty women.This study was performed on 30 patients with BC and 30 healty woman.GZMH and Estrogen levels were measured in cancer patients and healty women subsequently using ELISA and Radioimmunoassay[RIA] methods. Mean GZMH value was lower in BC than healty women[p<0.0001] and mean Estrogen level was higher in BC patients in comparison to healty women [p<0.003].Our finding indicates probability of existance of suppressor or a problem in production of GZMH in cancer patients

Comparative study of serum levels of perforin in prostate cancer and benign prostatic hyperplasia patients

Perforin[p] is the primary mediator of short term cytotoxicity, it is accumulated in response to proinflammatory cytokines and stored in T lymphocyte, NK cells and NKT cells are released upon activation. Perforin is a prototypical cytotoxic molecule involved in cell mediated immunity against various pathogens, alloantigens and particularly different tumors.The purpose of this study was to determine perforin level in prostate cancer [P.Ca] and Benign Prostatic Hyperplasia [BPH] This is study was performed on 59 patients consisting of 28 patients with P.Ca and 31 patients with BPH.Perforin and PSA levels were measured in cancer and BPH patients using ELISA method. Mean Perforin value was significantly lower in P.Ca patients than in BPH patients [p < 0.01] where as mean serum PSA level was significantly higher in the cancer patients in comparison to the BPH group [P < 0.01 Our finding indicate probability of problem in expression of cytotoxic molecule ,perforin in and around the tumor

[Geographical distribution and survival rate of cancers among elderly Iranians]

Objective [s]: To determine the pattern of incidence and survival rates of cancers in elderly adult in the period of five years to obligate the screening and therapeutic aged care services to old people

Methods: This is a historical cohort study based on the data analysis years [2001 to 2005] and cancer registries reporting survival rates for these cancers in people aged 60 years and older. Collecting data was through observation and data gathering Cancer Research Center, Shaheed Beheshti University of Medical Sciences. The inclusion criteria were cancer patients 60+ years registered through the annual reports of cancer cases and survival patients followed. To compare the survival and separation of sex Kaplan Meier coax method was used. The death and death of the relative risks of various cancers were calculated by regression model

Results: Based on data 33.5% of women surveyed aged 60 years and older and 66.5% were elderly men. The mean age was 71.2 years. Mean survival in this study was 88.2 years. The highest incidence of skin cancer was 5 years old. The geographical distribution of incidence was bladder cancer among elderly in Kermanshah province. Yazd province was the highest prevalence of common cancers in elderly. The average of five-year survival in Lorestan province was the highest and the Ardabil province had the lowest. The relationships between sex and death from cancers were [0.84 to 0.95], and the relationships between the relative risks of death from cancers [1.03 to 1.09] which were significant

Conclusion: The risks of cancer death among nine provinces were varied comparision to Tehran metropolitan. In oderwords survival rate of cancers in the nine provinces significantly were less than Tehran province

Changes in the muscle strength and functional performance of healthy women with aging

Lower limbs antigravity muscles weakness and decreased functional ability have significant role in falling. The aim of this study was to find the effects of aging on muscle strength and functional ability, determining the range of decreasing strength and functional ability and relationship between them in healthy women. Across-section study was performed on 101 healthy women aged 21-80 years. The participants were divided into six age groups. The maximum isometric strength of four muscle groups was measured using a hand-held dynamometer bilaterally. The functional ability was measured with functional reach [FR], timed get up and go [TGUG], single leg stance [SLS], and stairs walking [SW] tests. Muscle strength changes were not significant between 21-40 years of age, but decreased significantly thereafter. Also, there was a significant relationship between muscle strength and functional ability in age groups. Both muscle strength and functional ability is reduced as a result of aging, but the decrease in functional ability can be detected earlier

Neuroprotective properties of Melissa offtcinalis l. extract against ecstasy-induced neurotoxicity

The aim of the present study was to investigate the neuroprotective effects of Melissa officinalis, a major antioxidant plant, against neuron toxicity in hippocampal primary culture induced by 3,4-methylenedioxymethamphetamine [MDMA] or ecstasy, one of the most abused drugs, which causes neurotoxicity. 3-[4,5-dimethyl2 thiazoyl]2,5-diphenyketrazolium bromide [MTT] assay was used to assess mitochondrial activity, reflecting cell survival. Caspase-3 activity assay and Hoechst / propiedium iodide [PI] staining were done to show apoptotic cell death. A high dose of ecstasy caused profound mitochondrial dysfunction, around 40% less than the control value, and increased apoptotic neuronal death to around 35% more than the control value in hippocampal neuronal culture. Co-treatment with Melissa officinalis significantly reversed these damages to around 15% and 20% respectively of the MDMA alone group, and provided protection against MDMA-induced mitochondrial dysfunction and apoptosis in neurons. Melissa officinalis has revealed neuroprotective effects against apoptosis induced by MDMA in the primary neurons of hippocampal culture, which could be due to its free radical scavenging properties and monoamine oxidase [MAO] inhibitory effects

Differentiation of adipose-derived stem cells into schwann cell phenotype in comparison with bone marrow stem cells

Bone marrow is the traditional source of human multipotent mesenchymal stem cells [MSCs], but adipose tissue appears to be an alternative and more readily available source. In this study, rat adipose-derived stem cells [ADSCs] were induced to differentiate into Schwann-like cells and compared with rat bone marrow stem cells [BMSCs] for their Schwann-like cells differentiation potential. BMSCs and ADSCs were characterized for expression of MSCs-specific markers, osteogenic and adipogenic differentiation. They were induced to differentiate into Schwann-like cells and analyzed for expression of the Schwann specific markers. The immunocytochemical differentiation markers were S-100 and real time quantitative Real-time polymerase chain reaction [RT-PCR] markers were S100, P75 and glial fibrillary acidic protein [GFAP]. 3-[4, 5-Dimethylthiazol-2-yl]-2, 5-diphenyltetrazolium bromide [MTT] assay and Annexin V-Fluorescein isothiocyanate [FITC]/ Propidium iodide [PI] double labeling method were employed to detect early stage cell apoptosis. BMSCs and ADSCs showed similarities in expression of the MSC-specific markers, osteogenic and adipogenic differentiation. Both quantitative RT-PCR and immunocytochemical analysis demonstrated that BMSCs and ADSCs had equal expression of the Schwann-specific markers following Schwann-like cells differentiation. However, gene expression of P75 was higher in BMSCs compared with ADSCs. MTT assay and flow cytometry found that of the total BMSCs and ADSCs in the culture medium, 20% to 30% of the cells died, but the remaining cell population remained strongly attached to the substrate and differentiated. Comparative analysis showed that Schwann-like cell differentiation potential of ADSCs was slightly decreased in comparison with BMSCs. Therefore, BMSCs are more favorable choice than ADSCs for tissue engineering

[Medical Errors in the Health system]

Background: the health system is never as safe worldwide as everybody assumes. In recent years, many studies have been conducted to assess the magnitude of medical errors and its impact on the health system. This article reviews the studies performed in this issue to find out a strategy for approaching medical errors

Materials and methods: in a review literature, Pubmed was searched using these keywords error, medical and health system. In the complementary search, error mechanisms, error classification, reporting system and error reporting systems were also added to the search

Conclusions: medical errors are inevitable mishaps in the health system. Would there be a systematic approach in the health system for analyzing the errors and finding the root causes, the health system would maximize its benefits as much and possible future events with similar mechanism would be prevented

Results: in our health system, it is mandatory to introduce and improve such a system for quality improvement of the system

Induction of liver metallothionein contribute to the developmental toxicity of valproic acid in rat

There is an increased risk of neural tube defects and axial skeletal malformations among infants born by mothers who had received valproic acid. The aim of the present study is, if administration of valproic acid can induce maternal hepatic Metallothionein [MT] synthesis and so secondary decrease of plasma Zn. In the present experimental study, mated rats were divided into four groups of 12 animals each [control, valproic acid [VPA], valproic acid + zinc [VPA+ Zn] and Zinc [Zn] groups. The VPA group received 300 mg/kg valproic acid; daily. The control group received an equal volume of 0.9% NaCI. The VPA+ Zn group received 300 mg/kg VPA as well as 30 mg/kg zinc sulfate, and the Zn group received 30 mg/kg zinc sulfate, daily. These drugs were administered intraperitoneally from day 6 through day 15 of gestation. Dams were killed on GD 16 or 20. Blood was drawn to determine plasma zinc; furthermore, maternal liver Zn and MT were also determined. The zinc concentration in the plasma of rats treated with valproic acid was significantly lower than those of the other groups on GD 16 [p=0.004], but liver Zn [p=0.016] and MT [p=0.004] were significantly higher than those of the control group. On GD 20 the incidence of skeletal malformations and neural tube defects tended to be higher in VPA group than VPA+ Zn treated group and no anomalies were seen in the control group. The results from the present experiment support hypothesis that one of biochemical lesions causing the teratogenicity of VPA is a drug -induced maternal plasma zinc deficiency secondary to Metallothionein induction in liver

effect of nitric oxide on mouse Pre-implantation embryo development and apoptosis

Clinical studies have shown that in pathological conditions such as endometriosis and reproductive tract infection [male and female] there is an activation status of macrophages that produce large quantities of nitric oxide [NO] in addition to other effector molecules. Large amounts of NO may have embryotoxic roles and produce infertility. This study was designed to evaluate the effect of different concentrations of NO on mouse pre-implantation embryo development in vitro. Mouse embryos [2-cell stage] were cultured in media containing different concentrations of sodium nitroprusside [SNP], an NO donor, or L-arginine methyl ester [L-NAME], an NO syntase [NOS] inhibitor. At the end of culture, cell apoptosis was studied by the terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling [TUNEL] technique. The results showed that development of preimplantation embryos were inhibited by high concentration of SNP [1 and 10

Expression of alkaline phosphatase during ostesgenic differentiation of rat bone marrow stromal cells

Bone marrow contains a population of stem cells capable of differentiating to osteoblast and forming the bone nodule by dexamethasone. The stromal cells of bone marrow obtained from 4 to 6 weeks old Spruge-Dawely male rats were grown in primary culture for 7 days and subcultured for 18 days. The cells were cultured in either DMEM medium containing 15 percent fetal calf serum and antibiotics as the controls or the above medium supplemented with Osteogenic supplements [OS]: include 10 mM Na-Beta glycerophosphate [Na-Beta Gp][5] 10 nM dexamethasone [Dex] and 50 g/ml ascordic acid [AsA] as the examined cultures. After 6, 12 and 18 days of grow up in subculture, the cultures were examined for mineralization and alkaline phosphatase [Apase] expression. Mesenchymal stem cells [MSCs] in examined cultures underwent a dramatic change in cellular morphology and a significant increase in Apase activity by day 12. The deposition of a calcified matrix on the surface of the culture flasks became evident between days 12 and 18. The addition of osteogenic supplements [OS] to MSCs cultures induced Apase expression that contributes to cellular differentiation and mineralization of extracellular matrix