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Objectives: The percentage of shunt fraction significantly impacts the management of patients with congenital shunts, influencing strategic choices such as surgical or interventional procedures. This study compared the estimated shunt fraction (the ratio of pulmonary-to-systemic flow, Qp/Qs) for quantifying the left-to-right shunt in children with ventricular septal defect (VSD) using heart catheterization, four-dimensional (4D) flow, and two-dimensional (2D) flow magnetic resonance imaging (MRI). The goal was to establish a non-invasive and reliable measurement ratio between pulmonary and systemic blood flow in these patients. Methods: Between July 2022 and June 2023, patients scheduled to undergo invasive right heart catheterization were included in this study. MRI was performed one hour before the catheterization procedure. The correlation of shunt fraction was assessed between all methods after calculating the Qp/Qs ratio from 2D and 4D flow MRI and catheterization. Results: A total of 24 patients (aged 3-15 years, eight females) were ultimately included in the study. The Qp/Qs ratios obtained from 4D flow had a robust correlation (correlation coefficient r = 0.962) compared to those obtained during catheterization. Cardiac catheterization recorded the mean shunt fraction at 1.499 ± 0.396, while 4D flow measured it at 1.403 ± 0.344, with no significant difference between the two techniques. Moreover, there was a reasonable correlation (r = 0.894) between 2D flow measurements of Qp/Qs and the results obtained from catheterization, with a mean shunt fraction of 1.326 ± 0.283. Conclusion: 4D flow MRI has the potential to be a non-invasive method for accurately measuring the left-to-right shunt in children with VSD.
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Key Clinical Message: In this study, we introduced one of the rarest concomitants of the absence of left pulmonary artery (LPA), which was seen in our patient along with patent ductus arteriosus (PDA) and ventricular septal defect (VSD). Abstract: Unilateral absence of pulmonary artery (UAPA) is a congenital heart disease in association with other abnormalities such as tetralogy of Fallot and septal defects or isolated in 30% of cases and occurs in the right lung in two thirds of cases. Our case is a 33-year-old man who was hospitalized with symptoms of cough, shortness of breath, and hemoptysis. The echocardiography revealed a large ventricular septal defect, absent left pulmonary artery, and severe pulmonary hypertension (PH) along with patent ductus arteriosus. These findings were confirmed by CT angiography. This association has rarely been found in past studies. Due to PH and pulmonary infection, the patient was treated with intravenous prostaglandin and antibiotics. However, in cases of timely diagnosis and treatment of UAPA, fatal complications such as pulmonary hypertension, morbidity, and mortality are reduced. This case emphasizes the importance of awareness of this abnormality and its associated anomalies to enable early diagnosis and treatment.
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Attention is a fundamental aspect of human cognitive function and is crucial for essential activities such as learning, social interaction, and routine tasks. Notably, Auditory attention involves complex interactions and collaboration among multiple brain networks. Recognizing the impairment of auditory attention, comprehending its underlying mechanisms, and identifying the activated brain regions essential for the development of treatments and interventions for individuals facing auditory attention deficits, emphasizes the significance of investigating these matters. In the current study, we conducted a review by searching for the full text of 53 articles published related to auditory attention, mechanisms, and networks in databases like Science Direct, Google Scholar, ProQuest, and PubMed using the keywords Attention, Auditory Attention, Auditory Attention Impairment, theories of attention were investigated in the years 2000 to 2023 And focused on articles that provided discussions within this research domain. The studies have demonstrated that auditory attention exceeds being an acoustic attribute and assumes a fundamental role in complex acoustic environments, information processing, and even speech comprehension. In the context of this study, we have conducted a review and summary of the proposed theories related to attention and the brain networks involved in different forms of auditory attention. In conclusion, the integration of auditory attention assessments, behavioral observations, and an understanding of the neural mechanisms and brain regions implicated in auditory attention proves to be an effective approach for the diagnosis and treatment of attention-related disorders.
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Relative radiometric normalization (RRN) is a critical pre-processing step that enables accurate comparisons of multitemporal remote-sensing (RS) images through unsupervised change detection. Although existing RRN methods generally have promising results in most cases, their effectiveness depends on specific conditions, especially in scenarios with land cover/land use (LULC) in image pairs in different locations. These methods often overlook these complexities, potentially introducing biases to RRN results, mainly because of the use of spatially aligned pseudo-invariant features (PIFs) for modeling. To address this, we introduce a location-independent RRN (LIRRN) method in this study that can automatically identify non-spatially matched PIFs based on brightness characteristics. Additionally, as a fast and coregistration-free model, LIRRN complements keypoint-based RRN for more accurate results in applications where coregistration is crucial. The LIRRN process starts with segmenting reference and subject images into dark, gray, and bright zones using the multi-Otsu threshold technique. PIFs are then efficiently extracted from each zone using nearest-distance-based image content matching without any spatial constraints. These PIFs construct a linear model during subject-image calibration on a band-by-band basis. The performance evaluation involved tests on five registered/unregistered bitemporal satellite images, comparing results from three conventional methods: histogram matching (HM), blockwise KAZE, and keypoint-based RRN algorithms. Experimental results consistently demonstrated LIRRN's superior performance, particularly in handling unregistered datasets. LIRRN also exhibited faster execution times than blockwise KAZE and keypoint-based approaches while yielding results comparable to those of HM in estimating normalization coefficients. Combining LIRRN and keypoint-based RRN models resulted in even more accurate and reliable results, albeit with a slight lengthening of the computational time. To investigate and further develop LIRRN, its code, and some sample datasets are available at link in Data Availability Statement.
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A new, rapid, simple, and sensitive preconcentration method and Spectrophotometry determination technique have been presented for the microextraction and determination of trace amount of Tartrazine dye in food samples. In the present system, which is called "Magnetic stirring in syring dispersive liquid-liquid microextraction"(MSIS- DLLME), a cloudy state result is formed in a homemade glass syringe by magnetic agitation. In the MSIS-DLLME system, Tartrazine colour was uprooted into an organic detergent (Toluene) after many twinkles. Subsequently, the organic detergent which was placed on top of the result was transferred into a narrow neck by moving the piston overhead. The effective parameters on the extraction recovery were studied and optimized by Central Composite design (CCD). Under the optimum conditions, the estimation cure is direct in the range of 0.1-1(µg L- 1). The limit of detection (LOD), relative standard divagation and enrichment factor were 0.03 µg L -1, ±4.6 (n = 10) and 166, independently. The advanced system was successfully applied for microextraction of Tartrazine in food samples.
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BACKGROUND: The coronary artery calcium score (CACS) indicates cardiovascular health. A concern in this regard is the ionizing radiation from computed tomography (CT). Recent studies have tried to introduce low-dose CT techniques to assess CACS. We aimed to investigate the accuracy of iterative reconstruction (IR) and threshold modification while applying low tube voltage in coronary artery calcium imaging. METHODS: The study population consisted of 107 patients. Each subject underwent an electrocardiogram-gated CT twice, once with a standard voltage of 120 kVp and then a reduced voltage of 80 kVp. The standard filtered back projection (FBP) reconstruction was applied in both voltages. Considering Hounsfield unit (HU) thresholds other than 130 (150, 170, and 190), CACS was calculated using the FBP-reconstructed 80 kVp images. Moreover, the 80 kVp images were reconstructed utilizing IR at different strength levels. CACS was measured in each set of images. The intraclass correlation coefficient (ICC) was used to compare the CACSs. RESULTS: A 64% reduction in the effective dose was observed in the 80 kVp protocol compared to the 120 kVp protocol. Excellent agreement existed between CACS at high-level (strength level = 5) IR in low-kVp images and the standard CACS protocol in scores ≥ 11 (ICC > 0.9 and p < 0.05). Increasing the threshold density to 190 HU in FBP-reconstructed low-kVp images yielded excellent agreement with the standard protocol in scores ≥ 11 (ICC > 0.9 and p < 0.05) and good agreement in score zero (ICC = 0.84 and p = 0.02). CONCLUSIONS: The modification of the density threshold and IR provides an accurate calculation of CACS in low-voltage CT with the potential to decrease patient radiation exposure.
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Immunoglobulin G4-related disease (IgG4-RD) is a chronic fibro-inflammatory disorder of obscure etiology characterized by significant infiltration of IgG4-positive plasma cells toward several organs. Coronary artery involvement is rarely seen in IgG4-RD patients; thereby, we aim to outline the noninvasive imaging findings of this rare case. Cardiac magnetic resonance (CMR) and coronary computed tomography angiography (CCTA) from a 15-year-old female diagnosed with IgG4-RD via histopathological assessment of orbital biopsy, were analyzed. CMR showed a severely reduced left ventricular ejection fraction and akinesia of the basal to mid-lateral, anterior, and septal walls. Inflammation of the basal to apical lateral wall and subendocardial infarction of the basal to apical lateral and mid inferoseptal walls were also evident. CCTA findings showed stenosis in branches of the left main artery (LM), left anterior descending artery (LAD), and right coronary artery (RCA), aortitis, and aortic wall thickening. After courses of proper treatment with prednisolone, Cellcept, and adalimumab, follow-up CMR showed significant improvement in LV systolic function and resolution of inflammation. Although IgG4-RD is an uncommon cause of coronary artery disease, it can cause lethal complications such as myocardial infarction. Hence, clinicians should be aware of cardiac complications in these patients.
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The cabbage aphid, Brevicoryne brassicae L. (Hemiptera: Aphididae), is one of the important pests of cruciferous plants throughout the world including Iran. In the present study, we grew cultivated canola plants under different fertilizers or distilled water and sprayed them with 100 µM abscisic acid (ABA) or a control solution (NaOH dissolved in water) to study (i) the antibiosis parameters of B. brassicae on these plants; (ii) the antixenosis of B. brassicae adults on these plants; (iii) the plant's peroxidase (POD), polyphenol oxidase (PPO), and phenylalanine ammonia-lyase (PAL) activity; and (iv) the plant's total phenolic and glucosinolate content. The results of antibiosis experiments showed that ABA and fertilizers have a profound and negative effect on the performance of B. brassicae. In the antixenosis experiment, control plants attracted a significantly higher number of adult females in comparison to treated plants. Also, B. brassicae had lower performance and preference when they were reared on the ABA-treated fertilized plants with higher levels of phenolic and glucosinolate content. These results prompted us to hypothesize that fertilizers enable canola plants to trigger a higher level of secondary metabolites. Our findings reveal that the type and level of nutrient availability may have different impacts on how the plant regulates its defense mechanisms.
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Áfidos , Brassica napus , Femenino , Animales , Áfidos/fisiología , Ácido Abscísico , Glucosinolatos/metabolismo , Fertilizantes , Brassica napus/metabolismo , Fenoles , FitoquímicosRESUMEN
The role of various parasitic infections in the occurrence of appendicitis is illustrated through cases recorded all over the world. The purpose of the current study was to estimate the global prevalence of parasite infestation (other than E. vermicularis) in appendectomy specimens.In the setting of the PRISMA guidelines, multiple databases (Science Direct, Scopus, Web of Science, PubMed, and Google Scholar) were explored in articles published until 28 September 2020. Totally, 62 studies (106 datasets) with 77, 619 participants were included in the analysis.The pooled prevalence of parasites in appendectomy samples was as follows; 0.012% (95% CI; 0.004-0.025) for Ascaris lumbricoides, 0.004% (95% CI; 0.001-0.009) for Trichuris trichiura, 0.025% (95% CI; 0.007-0.052) for Schistosoma mansoni, 0.002% (95% CI; 0.001-0.005) for Taenia spp., 0.061% (95% CI; 0.020-0.122) for Entamoeba histolytica and 0.034% (95% CI; 0.018-0.056) for Giardia lamblia.Our results demonstrated that the risk of appendicitis may increase in the presence of helminth and protozoan infections. As such, the most cases of parasites in appendectomy specimens were reported in developing countries. Regular screening plans for diagnosis, treatment and prevention are needed for prevention of parasitic infection as well as parasitic associated appendicitis, especially in endemic regions of the world.
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Apendicitis , Parasitosis Intestinales , Parásitos , Animales , Apendicitis/epidemiología , Apendicitis/parasitología , Apendicitis/cirugía , Ascaris lumbricoides , Heces/parasitología , Humanos , Parasitosis Intestinales/epidemiología , Parasitosis Intestinales/parasitología , Prevalencia , Salud PúblicaRESUMEN
BACKGROUND: Decreasing signal intensity of the spleen assessed by T2* MRI is a frequent finding in patients with beta-thalassemia due to iron deposition within the reticuloendothelial cells in this organ. This parameter can also be applied to determine the candidates for blood cell transfusion. However, the association between splenic siderosis and iron overload in other vital organs such as heart and liver remains unclear. The present study aimed to assess the correlation between iron deposition in splenic, hepatic and myocardial tissues by T2* relaxometry technique. METHODS: This cross-sectional study included 39 consecutive patients with a definitive diagnosis of beta-thalassemia major who underwent spleen, liver and heart MRI examinations for iron deposition and cardiac function. RESULTS: No significant correlation was found between the heart and splenic T2* relaxation time (R=0.206, P=0.357). We revealed a strong correlation between the splenic T2* relaxation time and hepatic calculated T2*s (R=0.515, P=0.014). The liver T2* values can be predicted from the splenic T2*s by a new linear equation. According to the ROC curve analysis, the splenic T2* could significantly, but moderately predict moderate to severe from mild liver iron excess (AUC=0.667). CONCLUSION: Our study demonstrated a significant linear correlation between the splenic and hepatic T2* relaxation time, probably indicative of the same iron deposition mechanism, and made us available to write a linear model that would predict the deposited iron density in the spleen with the use of the magnetic resonance T2* values.
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OBJECTIVE: In hypertrophic cardiomyopathy (HCM), myocardial fibrosis is routinely shown by late gadolinium enhancement (LGE) in cardiac magnetic resonance (CMR) imaging. We evaluated the efficacy of 2 novel contrast-free CMR methods, namely, diffusion-weighted imaging (DWI) and feature-tracking (FT) method, in detecting myocardial fibrosis. METHODS: This cross-sectional study was conducted on 26 patients with HCM. Visual and quantitative comparisons were made between DWI and LGE images. Regional longitudinal, circumferential, and radial strains were compared between LGE-positive and LGE-negative segments. Moreover, global strains were compared between LGE-positive and LGE-negative patients as well as between patients with mild and marked LGE. RESULTS: All 3 strains showed significant differences between LGE-positive and LGE-negative segments (P < 0.001). The regional longitudinal and circumferential strain parameters showed significant associations with LGE (P < 0.001), while regional circumferential strain was the only independent predictor of LGE in logistic regression models (OR: 1.140, 95% CI: 1.073 to 1.207, P < 0.001). A comparison of global strains between patients with LGE percentages of below 15% and above 15% demonstrated that global circumferential strain was the only parameter to show impairment in the group with marked myocardial fibrosis, with borderline significance (P=0.09). A review of 212 segments demonstrated a qualitative visual agreement between DWI and LGE in 193 segments (91%). The mean apparent diffusion coefficient was comparable between LGE-positive and LGE-negative segments (P=0.51). CONCLUSIONS: FT-CMR, especially regional circumferential strain, can reliably show fibrosis-containing segments in HCM. Further, DWI can function as an efficient qualitative method for the estimation of the fibrosis extent in HCM.
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PURPOSE: This study was conducted to ascertain the efficacy of buccal injection of articaine compared to lidocaine in inducing palatal anesthesia in different maxillary regions. MATERIALS AND METHODS: This double-blinded, randomized clinical trial included 300 patients who referred for extraction of 1 maxillary tooth. The patients were categorized into 3 strata according to the extraction area (anterior, premolar, molar), and then randomly assigned to 2 groups based on the administered medication. The first group received buccal infiltration by 0.6 mL of 2% lidocaine, whereas the second group was buccally administered using 0.6 mL of 4% articaine. After a waiting period of 2 minutes, the failure or success in achieving palatal anesthesia was assessed by the instrumentation technique. In cases of failed anesthesia, an additional 0.6 mL of the same anesthetic was given, and the procedure was repeated if palatal anesthesia was not attained after a 2-minute delay. If pain remained 2 minutes after the third injection, a supplemental palatal infiltration was administered and the extraction was attempted. RESULTS: The success rate of buccal infiltration in achieving palatal anesthesia was 82.7% in the articaine group and 1.3% in the lidocaine group. There was a significant difference in the success rate and drug volume required to induce palatal anesthesia between the 2 groups (P < .001), but no significant difference was found between different maxillary regions, using either of the medications (P > .05). CONCLUSIONS: Articaine can be considered as a suitable alternative to lidocaine for eliminating painful palatal infiltration in the extraction of maxillary teeth.
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Anestesia Dental , Carticaína , Anestesia Local , Anestésicos Locales , Método Doble Ciego , Humanos , Lidocaína , Extracción DentalRESUMEN
The Coronavirus disease 2019 (COVID-19) presents open questions in how we clinically diagnose and assess disease course. Recently, chest computed tomography (CT) has shown utility for COVID-19 diagnosis. In this study, we developed Deep COVID DeteCT (DCD), a deep learning convolutional neural network (CNN) that uses the entire chest CT volume to automatically predict COVID-19 (COVID+) from non-COVID-19 (COVID-) pneumonia and normal controls. We discuss training strategies and differences in performance across 13 international institutions and 8 countries. The inclusion of non-China sites in training significantly improved classification performance with area under the curve (AUCs) and accuracies above 0.8 on most test sites. Furthermore, using available follow-up scans, we investigate methods to track patient disease course and predict prognosis.
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Betacoronavirus , Control de Enfermedades Transmisibles/organización & administración , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , COVID-19 , Humanos , Irán , SARS-CoV-2RESUMEN
Convolutional neural networks (CNNs) are extensively used in cardiac image analysis. However, heart localization has become a prerequisite to these networks since it decreases the size of input images. Accordingly, recent CNNs benefit from deeper architectures in gaining abstract semantic information. In the present study, a deep learning-based method was developed for heart localization in cardiac MR images. Further, Network in Network (NIN) was used as the region proposal network (RPN) of the faster R-CNN, and then NIN Faster-RCNN (NF-RCNN) was proposed. NIN architecture is formed based on "MLPCONV" layer, a combination of convolutional network and multilayer perceptron (MLP). Therefore, it could deal with the complicated structures of MR images. Furthermore, two sets of cardiac MRI dataset were used to evaluate the network, and all the evaluation metrics indicated an absolute superiority of the proposed network over all related networks. In addition, FROC curve, precision-recall (PR) analysis, and mean localization error were employed to evaluate the proposed network. In brief, the results included an AUC value of 0.98 for FROC curve, a mean average precision of 0.96 for precision-recall curve, and a mean localization error of 6.17 mm. Moreover, a deep learning-based approach for the right ventricle wall motion analysis (WMA) was performed on the first dataset and the effect of the heart localization on this algorithm was studied. The results revealed that NF-RCNN increased the speed and decreased the required memory significantly.
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Ventrículos Cardíacos/diagnóstico por imagen , Corazón/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Algoritmos , Aprendizaje Profundo , Diagnóstico por Computador , Corazón/anatomía & histología , Ventrículos Cardíacos/anomalías , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Redes Neurales de la Computación , Factores de TiempoRESUMEN
This study aimed to evaluate direct and indirect effects of the behavioral inhibition system (BIS) and the behavioral activation system (BAS) on depression and current suicidal ideation through rumination and self-reflection in a sample of suicide attempters. Three hundred suicide attempters completed the Rumination/Reflection Questionnaire (RRQ), the Carver and White BIS/BAS scales, the Beck Scale for Suicide Ideation (BSSI), and the Beck Depression Inventory-II (BDI-II). Results revealed that the BAS and BIS had direct effects on suicidal ideation but not depression. Low BAS had an indirect effect on depression through decreased self-reflection. High BIS had an indirect effect on depression via increased rumination. Low BAS and high BIS had indirect effects on suicidal ideation through decreased self-reflection. The findings suggest that low BAS and high BIS may be associated with depression and suicidal ideation in suicide attempters who have decreased self-reflection and increased rumination. Also, increasing self-reflection and reducing rumination as respectively adaptive and maladaptive self-focused attention strategies may prohibit depression and suicidal ideation.
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Depresión/psicología , Regulación Emocional , Inhibición Psicológica , Rumiación Cognitiva , Ideación Suicida , Intento de Suicidio , Adulto , Estudios Transversales , Femenino , Humanos , Irán/epidemiología , Masculino , Autocontrol/psicología , Suicidio/psicología , Intento de Suicidio/psicología , Intento de Suicidio/estadística & datos numéricos , Prevención del SuicidioRESUMEN
Death anxiety, obsession, and depression constitute three dimensions of death distress which can be influenced by religious coping in religious individuals. The aim of this study was to compare death anxiety, depression, and obsession between Muslims with positive and negative religious coping. In a cross-sectional study, a sample of 339 participants were selected via stratified random sampling method. The participants were screened using the Brief Religious Coping Scale, in which 60 individuals were identified to have positive religious coping and 62 individuals were recognized as individuals with negative religious coping. They responded to Death Anxiety Scale, Death Obsession Scale, and Death Depression Scale. The data were analyzed using factor analysis and multiple analysis of variance. The results of principal component analysis showed that death anxiety, death obsession, and death depression were separate factors of death distress. The results also revealed that individuals with negative religious coping gained higher scores than those with positive religious coping in all the three variables of death anxiety, obsession, and depression. Consistent with the previous studies and Terror Management Theory, this finding lays emphasis on the role of positive religious coping in reducing death distress and the possible consequent psychopathology.
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Adaptación Psicológica , Ansiedad/psicología , Actitud Frente a la Muerte , Depresión/psicología , Islamismo , Conducta Obsesiva/psicología , Trastornos de Ansiedad/complicaciones , Trastornos de Ansiedad/psicología , Estudios Transversales , Muerte , Trastorno Depresivo/complicaciones , Trastorno Depresivo/psicología , Humanos , Religión y PsicologíaRESUMEN
BACKGROUND: Advanced computed tomography (CT) scanners enable concurrent assessment of coronary artery anatomy and myocardial perfusion. The purpose of this study was to assess dual-energy CT images in a group of patients suspected for ischemic heart disease and to evaluate agreement of cardiac computed tomography perfusion (CTP) images with CT angiography results in a single dual-energy computed tomography (DECT) acquisition. METHODS: Thirty patients (mean age: 53.8 ± 12.9 years, 60% male) with angina pectoris or atypical chest pain, suspected for ischemic heart disease, were investigated using a 384-row detector CT scanner in dual-energy mode (DECT). Firstly, resting CTP images were acquired, and then from the same raw data, computed tomography angiography (CTA) studies were reconstructed for stenosis detection. CT-based dipyridamole-stress myocardial perfusion imaging was then performed in patients who exhibited coronary stenosis >50% or had myocardial bridge (MB). A color-coded iodine map was used for evaluation of myocardial perfusion defects using the 17-segment model. Two independent blinded readers analyzed all images for stenosis and myocardial perfusion defects. Different myocardial iodine content (mg/mL) was calculated by parametric tests. The kappa agreement was calculated between results of two methods in cardiac scans. RESULTS: All 30 CT angiograms were evaluated and assessment ability was 100% for combined CTA/CTP. According to the combined CT examination, 17 patients (56.7%) exhibited significant coronary stenosis and/or deep MB (DMB). A total of 510 myocardial segments and 90 vascular territories were analyzed. Coronary CTA demonstrated significant stenosis in 22 vessels (24.4% of all main coronary arteries) among 12 patients (40%), DMB in 6 vessels (6.7% of all main coronary arteries) in 17 out of 30 patients (56.7%). Twenty-eight out of 90 vascular territories (31.1%) and 41 out of 510 segments (8%) showed reversible perfusion defects on stress DECT. Kappa agreement between CTA and CTP results in whole heart was 0.79 (95% confidence interval=0.57-1). There were significant differences in mean iodine concentration between ischemic (0.59 ± 0.07 mg/mL) and normal segments (2.2 ± 0.15) with P < 0.001. CONCLUSION: Agreement of CTA and CTP in whole heart and in LAD considering DMB and significant CAD together were good to excellent; however, considering sole pathologies, most of the agreements were weak (<0.5). DECT with iodine quantification may provide a valuable method in comparison with previous methods for identifying both coronary stenosis and myocardial ischemia.
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Angiografía Coronaria , Estenosis Coronaria/diagnóstico por imagen , Isquemia Miocárdica/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adulto , Anciano , Estenosis Coronaria/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Isquemia Miocárdica/fisiopatología , Valor Predictivo de las Pruebas , Estudios ProspectivosRESUMEN
OBJECTIVES: Childhood maltreatment (CM) and cognitive emotion regulation strategies (CERSs) may be important in alcohol craving and dependence in alcohol-dependent individuals. The aim of this study was to evaluate direct effects of CM on the subscales of alcohol craving and alcohol dependence and its indirect effects via CERSs in individuals with a diagnosis of alcohol dependence. METHODS: In a cross-sectional design, 329 alcohol-dependent males completed the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Cognitive Emotion Regulation Questionnaire-Short version (CERQ-Short), the Alcohol Dependence Scale (ADS), the Obsessive Compulsive Drinking Scale (OCDS), and the Beck Depression Inventory-II (BDI-II). RESULTS: Participants with alcohol dependence had early age of onset of alcohol use (meanâ¯=â¯20.78 years), relatively long duration of alcohol use (meanâ¯=â¯11.14 years), and low education (meanâ¯=â¯9.55 years). Indirect effects were observed from CM to the subscales of alcohol craving and dependence only through maladaptive CERSs after adjusting for demographic and clinical factors. No direct effect was observed through CM on the subscales of alcohol craving and dependence. CONCLUSIONS: Although drawing causal conclusions from the current research is impossible, the findings suggest that maladaptive CERSs may be a possible mechanism relating CM to alcohol craving and dependence in treatment-seeking alcohol-dependent individuals, while adaptive CERSs may be less important regarding this relation. However, the findings of the current study need longitudinal research.
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Alcoholismo/psicología , Maltrato a los Niños/psicología , Trastornos del Conocimiento/psicología , Ansia , Regulación Emocional , Adulto , Experiencias Adversas de la Infancia , Alcoholismo/diagnóstico , Niño , Maltrato a los Niños/diagnóstico , Trastornos del Conocimiento/diagnóstico , Estudios Transversales , Trastorno Depresivo/diagnóstico , Trastorno Depresivo/psicología , Humanos , Irán , Masculino , Persona de Mediana Edad , Inventario de Personalidad , Adulto JovenRESUMEN
BACKGROUND: Coronary artery bypass grafting (CABG) surgery is widely accepted as a revascularization method for coronary artery disease (CAD). Despite survival benefit and improvement in quality of life, CABG may impose major morbidities and significant complications. Right ventricle (RV) dysfunction is an important complication that may affect patient's longevity and functional capacity. The aim of this study was to evaluate the relationship between RV dysfunction and some invisible parameters like inferior vena cava (IVC) size with physical capacity. METHODS: In this prospective study, 61 eligible CABG candidates were enrolled and RV function was assessed by echocardiographic parameters before CABG and one week and six months after the procedure, using tricuspid annular plane systolic excursion (TAPSE), Tei Index (TI), peak systolic movement (Sm) (cm/s), and IVC size. Functional capacity was assessed by six-minute walk test (6-MWT) 6 months after CABG. RESULTS: 58 patients who did not have any perioperative RV dysfunction were remained until the end of study; mean age was 58.2 ± 7.9 years with 68.9% being men, and 3 patients died after CABG. Preoperatively, septal motion, RV indices, and IVC size were normal in all patients. The frequency of RV dysfunction according to abnormal TAPSE index, TI, and peak Sm one week after surgery was 81.0%, 79.0%, and 62.0%, respectively, and 6 months after surgery was 49.0%, 49.0%, and 37.0%, respectively. Mean walked distance in 6-MWT was significantly less in patients with RV dysfunction, older age, and higher number of involved vessels (P < 0.001). CONCLUSION: The significant reduction in RV function and impairment of exercise capacity after CABG in this study suggests cardiologists to pay more attention to RV assessment in follow-up visits of patients undergoing GABG.