Body Image and Adjustment among Patients with Heart Rhythm Management Devices following Cardiac Rehabilitation Program: A Randomized, Controlled Clinical Trial.

Introduction: Heart rhythm management devices save patients' lives. However, they may cause problems with the patient's perspective of their body image. Therefore, given the significance of the heart function and cardiac rehabilitation, this study was conducted to investigate and compare the effect of the cardiac rehabilitation program on adjustment and body image among patients who use heart rhythm management devices.Methods: This two-group clinical trial was conducted with 100 patients who used various heart rhythm management devices. The patients were randomly assigned into either the control group or intervention group (50 patients in each group) via four triad blocks. The intervention was 16 sessions of the cardiac rehabilitation program and 4 telephone follow-ups over twelve weeks. Data was gathered before the intervention and both eight and twelve weeks after the intervention using the psychosocial adjustment to illness scale and the body image and relationships scale.Findings: The majority of the patients were male and in the age range of 40-60 years. Before the intervention, no statistically significant differences were reported between the groups in terms of adjustment control = 68.13 ± 9.1, intervention = 67.13 ± 4.6) and body image (control = 93.14 ± 8.5, intervention = 91.16 ± 8.4) (P>0.5). However, in the intervention group, with each of three devices (pacemaker, ICD, CRT), significant improvements were observed in all aspects of adjustment (16.7 ± 9.3, 25.3 ± 9.5, 20.6 ± 10.3) and body image (45.50 ± 9.80, 55.10 ± 8.80, 42.90 ± 6.10) over time respectively (P<0.001).Conclusion: The effectiveness of the cardiac rehabilitation program in improving the body image was reported in this study. Therefore, the cardiac rehabilitation program can have a vital role in improving body image and adjustment among patients who use various cardiac rhythm management devices.

Differentiating Between Low- and High-grade Glioma Tumors Measuring Apparent Diffusion Coefficient Values in Various Regions of the Brain.

OBJECTIVES: Our study aimed to apply the apparent diffusion coefficient (ADC) values to quantify the differences between low- and high-grade glioma tumors. METHODS: We conducted a multicenter, retrospective study between September to December 2019. Magnetic resonance imaging (MRI) diffusion-weighted images (DWIs), and the pathologic findings of 56 patients with glioma tumors (low grade = 28 and high grade = 28) were assessed to measure the ADC values in the tumor center, tumor edema, boundary area between tumor with normal tissue, and inside the healthy hemisphere. These values were compared between the two groups, and cut-off values were calculated using the receiver operating characteristic curve. RESULTS: We saw significant differences between the mean ADC values measured in the tumor center and edema between high- and low-grade tumors (p< 0.005). The ADC values in the boundary area between tumors with normal tissue and inside healthy hemisphere did not significantly differ in the groups. The ADC values at tumor center and edema were higher than 1.12 × 10-3 mm2/s (sensitivity = 100% and specificity = 96.0%) and 1.15 × 10-3 mm2/s (sensitivity = 75.0% and specificity = 64.0%), respectively, could be classified as low-grade tumors. CONCLUSIONS: The ADC values from the MRI DWIs in the tumor center and edema could be used as an appropriate method for investigating the differences between low- and high-grade glioma tumors. The ADC values in the boundary area and healthy tissues had no diagnostic values in grading the glioma tumors.

Sensitivity to Antibiotics of Bacteria Exposed to Gamma Radiation Emitted from Hot Soils of the High Background Radiation Areas of Ramsar, Northern Iran.

BACKGROUND: Over the past several years our laboratories have investigated different aspects of the challenging issue of the alterations in bacterial susceptibility to antibiotics induced by physical stresses. OBJECTIVE: To explore the bacterial susceptibility to antibiotics in samples of Salmonella enterica subsp. enterica serovar Typhimurium (S. typhimurium), Staphylococcus aureus, and Klebsiella pneumoniae after exposure to gamma radiation emitted from the soil samples taken from the high background radiation areas of Ramsar, northern Iran. METHODS: Standard Kirby-Bauer test, which evaluates the size of the zone of inhibition as an indicator of the susceptibility of different bacteria to antibiotics, was used in this study. RESULTS: The maximum alteration of the diameter of inhibition zone was found for K. pneumoniae when tested for ciprofloxacin. In this case, the mean diameter of no growth zone in non-irradiated control samples of K. pneumoniae was 20.3 (SD 0.6) mm; it was 14.7 (SD 0.6) mm in irradiated samples. On the other hand, the minimum changes in the diameter of inhibition zone were found for S. typhimurium and S. aureus when these bacteria were tested for nitrofurantoin and cephalexin, respectively. CONCLUSION: Gamma rays were capable of making significant alterations in bacterial susceptibility to antibiotics. It can be hypothesized that high levels of natural background radiation can induce adaptive phenomena that help microorganisms better cope with lethal effects of antibiotics.

Abdominal fat distribution and carotid atherosclerosis in a general population: a semi-automated method using magnetic resonance imaging.

PURPOSE: Available evidence suggests functional differences in visceral and subcutaneous fat. We investigated the association between quantitative measures of central adiposity with indicators of carotid atherosclerosis including intima-media thickness (IMT) and plaque in a general population using a semi-automated method on magnetic resonance imaging (MRI) data. METHODS: In this cross-sectional study 200 subjects (52 % female), aged 50-77 years, were randomly selected from Golestan Cohort Study. Participants underwent ultrasound examination of carotid arteries and abdominal MRI. Segmentation and calculation of visceral (VFA) and subcutaneous fat area (SFA) were performed on three levels using semi-automated software. Various conventional anthropometric indices were also measured. RESULTS: Among 191 enrolled subjects, 77 (40 %) participants had IMT ≥0.8 mm. Carotid plaques were detected in 86 (44 %) subjects. In separate multivariate analysis models, unlike SFA and other anthropometric indices, the last tertile of VFA values was associated with at least threefold excess risk for IMT ≥0.8 mm (OR 3.8, 95 % CI 1.36-6.94, p = 0.02). There was no significant difference between mean values of categorized obesity indices in subjects with and without plaque, while participants in the highest tertile of VFA values were demonstrated to have higher risk of more than one plaque (OR 4.57, 95 % CI 1.03-20.11, p = 0.034). CONCLUSIONS: A higher amount of visceral fat, measured by a semi-automated technique using MRI, is associated with increased IMT and having more than one carotid plaque in a general population, while subcutaneous fat measures are poor indicators for identifying carotid atherosclerosis.