Associations of emotional social support, depressive symptoms, chronic stress, and anxiety with hard cardiovascular disease events in the United States: the multi-ethnic study of atherosclerosis (MESA).

BACKGROUND: Cardiovascular diseases (CVDs) are a major cause of morbidity and mortality around the globe and psychosocial factors are not sufficiently understood. AIM: In the current study, we aimed to evaluate the role of different psychosocial factors including depressive symptoms, chronic stress, anxiety, and emotional social support (ESS) on the incidence of hard CVD (HCVD). METHODS: We examined the association of psychosocial factors and HCVD incidence amongst 6,779 participants in the Multi-Ethnic Study of Atherosclerosis (MESA). Using physician reviewers' adjudication of CVD events incident, depressive symptoms, chronic stress, anxiety, emotional social support scores were measured by validated scales. We used Cox proportional Hazards (PH) models with psychosocial factors in several of the following approaches: (1) Continuous; (2) categorical; and (3) spline approach. No violation of the PH was found. The model with the lowest AIC value was chosen. RESULTS: Over an 8.46-year median follow-up period, 370 participants experienced HCVD. There was not a statistically significant association between anxiety and HCVD (95%CI) for the highest versus the lowest category [HR = 1.51 (0.80-2.86)]. Each one point higher score for chronic stress (HR, 1.18; 95% CI, 1.08-1.29) and depressive symptoms (HR, 1.02; 95% CI, 1.01-1.03) was associated with a higher risk of HCVD in separate models. In contrary, emotional social support (HR, 0.98; 95% CI, 0.96-0.99) was linked with a lower risk of HCVD. CONCLUSIONS: Higher levels of chronic stress is associated with greater risk of incident HCVD whereas ESS has a protective association.

Entropic Density Functional Theory.

A formulation of density functional theory (DFT) is constructed as an application of the method of maximum entropy for an inhomogeneous fluid in thermal equilibrium. The use of entropy as a systematic method to generate optimal approximations is extended from the classical to the quantum domain. This process introduces a family of trial density operators that are parameterized by the particle density. The optimal density operator is that which maximizes the quantum entropy relative to the exact canonical density operator. This approach reproduces the variational principle of DFT and allows a simple proof of the Hohenberg-Kohn theorem at finite temperature. Finally, as an illustration, we discuss the Kohn-Sham approximation scheme at finite temperature.

Examining memory performance in body dysmorphic disorder (BDD): A comparison study with obsessive compulsive disorder (OCD).

The aim of this study is comparing directly the BDD and OCD disorders in terms of similarities and differences in memory function for the first time. 19 BDD patients, 15 OCD patients and 26 individuals in a healthy control group were recruited from three hospitals in Tehran. They were administered the following subtests of the Wechsler Memory Scale: logical memory (immediate and delayed), verbal paired association (immediate and delayed), digit span and spatial span as well as the Rey-Osterrieth complex figure test (RCFT). The results showed that BDD and OCD groups had lower performance in comparison to the control group across all measures, except for the immediate memory of the verbal paired associate task, which was similar across the three groups. Both the BDD and OCD groups showed poor performance on the auditory-verbal memory tasks. However, only the BDD group showed poor performance in the visual domain (i.e. spatial span and RCFT). This suggest that memory deficits are similar between BDD and OCD patients in the verbal domain. Furthermore, BDD patients demonstrated poorer visual working memory. The findings of this study reveal that BDD and OCD patients have more similarities than differences regarding neuropsychological features, in other words, the idea of the incorporation of BDD within the obsessive-compulsive and related disorders (OCRDs) spectrum in DSM-5 is supported, at least through the viewpoint of neuropsychology.

Immune Response to the Mumps Virus in Iranian Unvaccinated Young Adults.

Although the first mumps vaccine was licensed more than 50 years ago, the vaccine was added to Iran's Expanded Program on Immunization in 2003. Therefore, the majority of Iranians born before 2003 are unvaccinated, and their immunity is the result of natural infection. In order to evaluate cellular responses against the mumps virus following natural infection, we investigated 90 Iranian unvaccinated adults aged 20-30 years. Mumps specific memory CD4+ and CD8+ proliferation and frequency of cytotoxic lymphocyte CD8+ CD107a were evaluated using flow cytometry. Our results showed that 33 subjects were seronegative, but 28 of them showed degranulation of CD8+ T lymphocytes and expression of CD 107a, as well as proliferation of CD4 and CD8 T cells, in response to mumps antigen stimulation. In all seropositive subjects, degranulation of cytotoxic T lymphocytes and proliferation of CD4+ and CD8+ T lymphocytes was detected. Proliferation of T cells and degranulation of CD8 T cells in seropositive subjects was higher than in seronegative subjects. We conclude that natural mumps infection and subclinical reinfection could induce good protection, but the severe complications associated with mumps infections suggest the need for mumps vaccination. Natural boosters because of the prevalence of the wild-type virus may help with maintenance of immunity in populations with high vaccine coverage.

A Double-Blind Randomized Trial Comparing the Effectiveness and Safety of Nifedipine and Isosorbide Dinitrate in Chronic Anal Fissure.

BACKGROUND: Chronic anal fissure is a common disease that is accompanied with pain and bleeding during defecation. Various surgical and non-surgical methods have been offered for the treatment of this condition. The aim of this randomised clinical study was to compare the effectiveness and safety of nifedipine and isosorbide dinitrate (ISDN) in the treatment of chronic anal fissure. METHODS: This double-blind clinical trial study was performed on patients aged 20 to 60 years old in 2012 to 2013. The samples with a primary diagnosis of chronic anal fissure were enrolled from the patients admitted to public treatment at the educational Imam Ali Clinic, Shahrekord, Iran by researchers and general surgery specialists. The patients were randomised into two groups: nifedipine 0.3% (n = 35) or ISDN 0.2% (n = 35) applied three times a day for three weeks. The patients were examined on the 7th, 14th, and 21st days of treatment, and the symptoms including bleeding, pain, and healing status, as well as the side effects of the drugs, were assessed. Pain was evaluated using a visual analogue scale (VAS). RESULTS: After 21 days of follow-up, complete healing was achieved in 77.1% (n = 27) of patients in the nifedipine group and 51.4% (n = 18) in the ISDN group (P = 0.05). The mean VAS of the pain on day 21 was 0.91 (SD 0.01) in the ISDN group and 0.45±0.78 in the nifedipine group, with a statistically significant difference (P = 0.038). The bleeding was similar in the two groups (P = 0.498). CONCLUSION: In view of the findings on healing status and pain in the patients, nifedipine may be significantly more effective in the treatment of chronic anal fissure than ISDN.

A Double-Blind Randomized Trial Comparing the Effectiveness and Safety of Nifedipine and Isosorbide Dinitrate in Chronic Anal Fissure

Background: Chronic anal fissure is a common disease that is accompanied with pain and bleeding during defecation. Various surgical and non-surgical methods have been offered for the treatment of this condition. Objective: The aim of this randomised clinical study was to compare the effectiveness and safety of nifedipine and isosorbide dinitrate (ISDN) in the treatment of chronic anal fissure. Methods: This double-blind clinical trial study was performed on patients aged 20 to 60 years old in 2012 to 2013. The samples with a primary diagnosis of chronic anal fissure were enrolled from the patients admitted to public treatment at the educational Imam Ali Clinic, Shahrekord, Iran by researchers and general surgery specialists. The patients were randomised into two groups: nifedipine 0.3% (n = 35) or ISDN 0.2% (n = 35) applied three times a day for three weeks. The patients were examined on the 7th, 14th, and 21st days of treatment, and the symptoms including bleeding, pain, and healing status, as well as the side effects of the drugs, were assessed. Pain was evaluated using a visual analogue scale (VAS). Results: After 21 days of follow-up, complete healing was achieved in 77.1% (n = 27) of patients in the nifedipine group and 51.4% (n = 18) in the ISDN group (P = 0.05). The mean VAS of the pain on day 21 was 0.91 (SD 0.01) in the ISDN group and 0.45±0.78 in the nifedipine group, with a statistically significant difference (P = 0.038). The bleeding was similar in the two groups (P = 0.498). Conclusion: In view of the findings on healing status and pain in the patients, nifedipine may be significantly more effective in the treatment of chronic anal fissure than ISDN.

Posterior hip dislocation associated with posterior wall acetabular fracture and ipsilateral intertrochantric fracture: a very rare case report.

ABSTRACT: Traumatic hip dislocations are common in high-energy motor vehicle accidents. We present a case of a 43-year old man who sustained posterior hip dislocation with posterior wall acetabular fracture and ipsilateral intertrochantric fracture following a motorcycle accident. Urgent open reduction and internal fixation of the hip fracture-dislocation and fixation of intertrochantric fracture with a dynamic hip screw were done. To our knowledge, such an injury has been rarely reported in the literature. Possible mechanisms of injury and operative procedures are discussed. Radiographic follow-up after eight months showed union. No major complications were observed in our patient.

Investigation of LRTOMT gene (locus DFNB63) mutations in Iranian patients with autosomal recessive non-syndromic hearing loss.

Hearing loss (HL) is the most frequent sensory defect affecting 1 in 1000 neonates. This can occur due to genetic or environmental causes or both. The genetic causes are very heterogenous and over 100 loci have been identified to cause autosomal recessive non - syndromic hearing loss (ARNSHL). The aim of this study was to determine the contribution of the LRTOMT gene mutations in causing ARNSHL. One hundred fifty seven pupils affected with ARNSHL from Azarbaijan Sharghi, Kordestan, Gilan and Golestan provinces, north and west of Iran, were ascertained. In this descriptive - laboratory study, the presence of LRTOMT mutations were initially checked using PCR - Single - strand conformation polymorphism (SSCP) and heteroduplex analysis (HA) strategy. Samples with shifted bands on the gel were confirmed by DNA sequencing method. The PCR-SSCP/HA and the subsequent direct DNA sequencing showed no mutation in the population studied. We conclude that LRTOMT mutations have no role in causing sporadic deafness in the studied population. Further studies on other populations and samples could clarify the exact role of LRTOMT mutations.

Importance of gated imaging in both phases of myocardial perfusion SPECT: myocardial stunning after dipyridamole infusion.

We present the case report of a 72-y-old woman who underwent (99m)Tc-sestamibi gated myocardial perfusion SPECT with a 2-d protocol. SPECT images revealed ischemia of the apical, anteroapical, apicoseptal, and septal walls. Postdipyridamole gated SPECT revealed significant deterioration in the left ventricular ejection fraction (LVEF), wall motion, and systolic wall thickening relative to the findings obtained with rest gated SPECT. Myocardial stunning is a lingering contractile dysfunction that occurs after a brief ischemic insult. Myocardial stunning after dynamic exercise or pharmacologic stress tests has been demonstrated. Thus, the use of gated SPECT in both phases of perfusion studies may add useful information about cardiac function, as a poststress study alone probably reflects stunned myocardium in some patients undergoing ischemic stress tests. The difference between poststress LVEF and rest LVEF may have a powerful impact on prognosis, as it seems to depend on the extent and severity of induced ischemia.