Pub Date : 2023-12-01eCollection Date: 2023-01-01DOI: 10.31661/gmj.v12i0.3126
Ahmad Separham, Naser Aslan-Abadi, Hamid Sedigh, Reza Javan-Ajdadi, Kazem Mehravani
Background: The purpose of this study was to assess the prognostic value of the monocyte-to-high-density lipoprotein ratio (MHR) as a marker of inflammation in patients diagnosed with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI).
Materials and methods: This retrospective cross-sectional study was conducted on patients with a diagnosis of STEMI who underwent PCI between March 2021 and March 2022 at Madani Training and Research Hospital in Tabriz, Iran. Data regarding clinical and demographic properties, and laboratory parameters were obtained from medical records. Patients were categorized into two groups according to the median of admission MHR.
Results: The study population consisted of 652 patients, 378 males (58%), and 275 females (42%), with a median age of 68 years (interquartile range: 57-77). Results showed that groups with higher MHR (15.59) had higher rates of in-hospital mortality and higher major adverse cardiovascular events (MACEs) in comparison with the group featuring lower MHR (15.59). Receiver operating characteristic (ROC) curves demonstrated that MHR could predict in-hospital mortality with a 75.7% sensitivity and 53.5% specificity, as well as predict MACE with 60.2% sensitivity and 59.7% specificity. Multivariate analyses indicated that MHR is an independent predictor of both in-hospital mortality (OR 1.05, 95% CI 1.02-1.08, P=0.002) and MACE (OR 1.05, 95% CI 1.02-1.08, P0.001).
Conclusion: This research indicated that the rise in MHR was independently associated with a higher risk of MACE and in-hospital mortality in STEMI patients undergoing primary PCI.
研究背景本研究的目的是评估单核细胞与高密度脂蛋白比值(MHR)作为炎症标志物在确诊为 ST 段抬高型心肌梗死(STEMI)并接受初级经皮冠状动脉介入治疗(PCI)的患者中的预后价值:这项回顾性横断面研究的对象是2021年3月至2022年3月期间在伊朗大不里士市马达尼培训与研究医院接受PCI治疗的STEMI患者。研究人员从病历中获取了患者的临床、人口统计学特征和实验室参数数据。根据入院 MHR 的中位数将患者分为两组:研究对象包括 652 名患者,其中男性 378 名(占 58%),女性 275 名(占 42%),中位年龄为 68 岁(四分位距:57-77)。结果显示,MHR(15.59)较高的组别与MHR(15.59)较低的组别相比,院内死亡率和主要不良心血管事件(MACE)均较高。接收者操作特征(ROC)曲线显示,MHR 预测院内死亡率的灵敏度为 75.7%,特异度为 53.5%,预测 MACE 的灵敏度为 60.2%,特异度为 59.7%。多变量分析表明,MHR是院内死亡率(OR 1.05,95% CI 1.02-1.08,P=0.002)和MACE(OR 1.05,95% CI 1.02-1.08,P0.001)的独立预测因子:该研究表明,MHR的升高与接受初级PCI治疗的STEMI患者发生MACE和院内死亡的风险较高密切相关。
{"title":"Assessment of the Prognostic Value of Monocyte-to-HDL Ratio in ST-Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention.","authors":"Ahmad Separham, Naser Aslan-Abadi, Hamid Sedigh, Reza Javan-Ajdadi, Kazem Mehravani","doi":"10.31661/gmj.v12i0.3126","DOIUrl":"10.31661/gmj.v12i0.3126","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to assess the prognostic value of the monocyte-to-high-density lipoprotein ratio (MHR) as a marker of inflammation in patients diagnosed with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI).</p><p><strong>Materials and methods: </strong>This retrospective cross-sectional study was conducted on patients with a diagnosis of STEMI who underwent PCI between March 2021 and March 2022 at Madani Training and Research Hospital in Tabriz, Iran. Data regarding clinical and demographic properties, and laboratory parameters were obtained from medical records. Patients were categorized into two groups according to the median of admission MHR.</p><p><strong>Results: </strong>The study population consisted of 652 patients, 378 males (58%), and 275 females (42%), with a median age of 68 years (interquartile range: 57-77). Results showed that groups with higher MHR (15.59) had higher rates of in-hospital mortality and higher major adverse cardiovascular events (MACEs) in comparison with the group featuring lower MHR (15.59). Receiver operating characteristic (ROC) curves demonstrated that MHR could predict in-hospital mortality with a 75.7% sensitivity and 53.5% specificity, as well as predict MACE with 60.2% sensitivity and 59.7% specificity. Multivariate analyses indicated that MHR is an independent predictor of both in-hospital mortality (OR 1.05, 95% CI 1.02-1.08, P=0.002) and MACE (OR 1.05, 95% CI 1.02-1.08, P0.001).</p><p><strong>Conclusion: </strong>This research indicated that the rise in MHR was independently associated with a higher risk of MACE and in-hospital mortality in STEMI patients undergoing primary PCI.</p>","PeriodicalId":44017,"journal":{"name":"Galen Medical Journal","volume":"12 ","pages":"1-9"},"PeriodicalIF":0.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11568425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Separham, Naser Aslan-abadi, H. Sedigh, Reza Javan-ajdadi, Kazem Mehravani
Background: The purpose of this study was to assess the prognostic value of the monocyte-to-high-density lipoprotein ratio (MHR) as a marker of inflammation in patients diagnosed with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI). Materials and Methods: This retrospective cross-sectional study was conducted on patients with a diagnosis of STEMI who underwent PCI between March 2021 and March 2022 at Madani Training and Research Hospital in Tabriz, Iran. Data regarding clinical and demographic properties, and laboratory parameters were obtained from medical records. Patients were categorized into two groups according to the median of admission MHR. Results: The study population consisted of 652 patients, 378 males (58%), and 275 females (42%), with a median age of 68 years (interquartile range: 57-77). Results showed that groups with higher MHR (>15.59) had higher rates of in-hospital mortality and higher major adverse cardiovascular events (MACEs) in comparison with the group featuring lower MHR (<15.59). Receiver operating characteristic (ROC) curves demonstrated that MHR could predict in-hospital mortality with a 75.7% sensitivity and 53.5% specificity, as well as predict MACE with 60.2% sensitivity and 59.7% specificity. Multivariate analyses indicated that MHR is an independent predictor of both in-hospital mortality (OR 1.05, 95% CI 1.02-1.08, P=0.002) and MACE (OR 1.05, 95% CI 1.02-1.08, P<0.001). Conclusion: This research indicated that the rise in MHR was independently associated with a higher risk of MACE and in-hospital mortality in STEMI patients undergoing primary PCI.
背景:本研究的目的是评估单核细胞与高密度脂蛋白比率(MHR)作为st段抬高型心肌梗死(STEMI)患者接受原发性经皮冠状动脉介入治疗(PCI)的炎症标志物的预后价值。材料和方法:这项回顾性横断面研究是在伊朗大不里士的Madani培训和研究医院对诊断为STEMI并于2021年3月至2022年3月期间接受PCI治疗的患者进行的。从医疗记录中获得有关临床和人口统计学特征以及实验室参数的数据。根据入院MHR中位数将患者分为两组。结果:研究人群包括652例患者,其中男性378例(58%),女性275例(42%),中位年龄为68岁(四分位数范围:57-77)。结果显示,与MHR较低组(<15.59)相比,MHR较高组(>15.59)的住院死亡率和主要心血管不良事件(mace)发生率较高。受试者工作特征(ROC)曲线显示,MHR预测住院死亡率的敏感性为75.7%,特异性为53.5%;预测MACE的敏感性为60.2%,特异性为59.7%。多因素分析表明,MHR是院内死亡率(OR 1.05, 95% CI 1.02-1.08, P=0.002)和MACE (OR 1.05, 95% CI 1.02-1.08, P<0.001)的独立预测因子。结论:本研究表明,MHR的升高与STEMI患者接受初级PCI时MACE和住院死亡率的升高独立相关。
{"title":"Evaluation of the prognostic value of monocyte to HDL ratio (MHR) in primary PCI STEMI patients","authors":"A. Separham, Naser Aslan-abadi, H. Sedigh, Reza Javan-ajdadi, Kazem Mehravani","doi":"10.31661/gmj.v12i.3126","DOIUrl":"https://doi.org/10.31661/gmj.v12i.3126","url":null,"abstract":"Background: The purpose of this study was to assess the prognostic value of the monocyte-to-high-density lipoprotein ratio (MHR) as a marker of inflammation in patients diagnosed with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI). Materials and Methods: This retrospective cross-sectional study was conducted on patients with a diagnosis of STEMI who underwent PCI between March 2021 and March 2022 at Madani Training and Research Hospital in Tabriz, Iran. Data regarding clinical and demographic properties, and laboratory parameters were obtained from medical records. Patients were categorized into two groups according to the median of admission MHR. Results: The study population consisted of 652 patients, 378 males (58%), and 275 females (42%), with a median age of 68 years (interquartile range: 57-77). Results showed that groups with higher MHR (>15.59) had higher rates of in-hospital mortality and higher major adverse cardiovascular events (MACEs) in comparison with the group featuring lower MHR (<15.59). Receiver operating characteristic (ROC) curves demonstrated that MHR could predict in-hospital mortality with a 75.7% sensitivity and 53.5% specificity, as well as predict MACE with 60.2% sensitivity and 59.7% specificity. Multivariate analyses indicated that MHR is an independent predictor of both in-hospital mortality (OR 1.05, 95% CI 1.02-1.08, P=0.002) and MACE (OR 1.05, 95% CI 1.02-1.08, P<0.001). Conclusion: This research indicated that the rise in MHR was independently associated with a higher risk of MACE and in-hospital mortality in STEMI patients undergoing primary PCI.","PeriodicalId":44017,"journal":{"name":"Galen Medical Journal","volume":" 10","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138619180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Baback Khanegheini, Afsaneh Ghasemi, Mohammad Amin Heidari, Kamkar Aeinfar, Sina Firoozi, Mona Tamaddon, Zhila Fereidouni
{"title":"Role of MicroRNAs in Breast Cancer Metastasis to the Brain: A New Therapeutic Perspective","authors":"Baback Khanegheini, Afsaneh Ghasemi, Mohammad Amin Heidari, Kamkar Aeinfar, Sina Firoozi, Mona Tamaddon, Zhila Fereidouni","doi":"10.31661/gmj.v12i.3193","DOIUrl":"https://doi.org/10.31661/gmj.v12i.3193","url":null,"abstract":"","PeriodicalId":44017,"journal":{"name":"Galen Medical Journal","volume":"7 12","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138624009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Heart failure (HF), a worldwide epidemic with significant morbidity and mortality risks, is frequently secondary to cardiovascular disorders and probably is the common final way to survive patients. Almost 25% of hospitalized patients with acute HF are expected to be readmitted within 30 days post-discharge, and the rates of rehospitalization increase to almost one-third at 60 days and 60 percent within one year of discharge. Although care planning for patients with heart failure is complex, multidisciplinary, and resource-dependent, optimal self-care management along with appropriate educational intervention and follow-up strategy could be able to reduce readmissions, decline the duration of hospitalization, increase life expectancy, decrease the rates of mortality, and reduce costs of healthcare services for patients with HF. However, there are contradictions in previous reports about the efficacy of self-care, mainly due to patients’ non-adherence to self-care behaviors. Therefore, the current study aimed to review the investigations on the effectiveness of self-care of HF patients in reducing hospital readmissions and increasing quality of life, and discuss novel approaches for predischarge educational interventions and postdischarge follow-up strategies.
{"title":"The Efficacy of Self-care Behaviors, Educational Interventions, and Follow-up Strategies on Hospital Readmission and Mortality Rates in Patients with Heart Failure","authors":"Zahra Khosravirad, Mohammad Rostamzadeh, Shiva Azizi, Mehran Khodashenas, Babak Khodadoustan Shahraki, Farangis Ghasemi, Maryam Ghorbanzadeh","doi":"10.31661/gmj.v12i.3116","DOIUrl":"https://doi.org/10.31661/gmj.v12i.3116","url":null,"abstract":"Heart failure (HF), a worldwide epidemic with significant morbidity and mortality risks, is frequently secondary to cardiovascular disorders and probably is the common final way to survive patients. Almost 25% of hospitalized patients with acute HF are expected to be readmitted within 30 days post-discharge, and the rates of rehospitalization increase to almost one-third at 60 days and 60 percent within one year of discharge. Although care planning for patients with heart failure is complex, multidisciplinary, and resource-dependent, optimal self-care management along with appropriate educational intervention and follow-up strategy could be able to reduce readmissions, decline the duration of hospitalization, increase life expectancy, decrease the rates of mortality, and reduce costs of healthcare services for patients with HF. However, there are contradictions in previous reports about the efficacy of self-care, mainly due to patients’ non-adherence to self-care behaviors. Therefore, the current study aimed to review the investigations on the effectiveness of self-care of HF patients in reducing hospital readmissions and increasing quality of life, and discuss novel approaches for predischarge educational interventions and postdischarge follow-up strategies.","PeriodicalId":44017,"journal":{"name":"Galen Medical Journal","volume":"14 17","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138624920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Application of ChatGPT in Medical Content Development: Challenges and Hope","authors":"Akhilesh Vikram Singh, Anudwipa Singh","doi":"10.31661/gmj.v12i.3106","DOIUrl":"https://doi.org/10.31661/gmj.v12i.3106","url":null,"abstract":"","PeriodicalId":44017,"journal":{"name":"Galen Medical Journal","volume":" 5","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138620261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Takotsubo cardiomyopathy accounts for 1% of acute coronary syndrome presentations and has been increasingly recognized.1 Reverse Takotsubo cardiomyopathy, a variant form of Takotsubo cardiomyopathy has been described which presents with hyperdynamic function of the apical segments and hypokinesis of the basal or mid-ventricular segments, is the rarest type of acute stress cardiomyopathy, with mid-ventricular akinesia and preservation of apical and basal contractility.2 Case Report: We report the rare case of an elderly lady admitted to our intensive care unit (ICU) with acute respiratory failure due to exacerbation of chronic obstructive lung disease and heart failure. Echocardiography revealed reverse Takotsubo cardiomyopathy. Cardiac catheterization showed nonobstructive coronary artery disease. The wall motion abnormalities resolved in 2 weeks. The case is unique in that she had an identical presentation one year earlier after she had entered the same dusty room! Conclusion: This case demonstrates that reverse Takotsubo cardiomyopathy with identical wall motion abnormalities can recur in a patient when re-exposed to similar stressful situation. Early recognition and appropriate management can prevent catastrophic outcomes.
{"title":"Broken Heart Syndrome: A Rare Case of Recurrent Reverse Takotsubo Cardiomyopathy Associated with Acute Respiratory Failure","authors":"Samina Jabeen, Deepak Pattanshetty","doi":"10.31661/gmj.v12i.3103","DOIUrl":"https://doi.org/10.31661/gmj.v12i.3103","url":null,"abstract":"Background: \u0000Takotsubo cardiomyopathy accounts for 1% of acute coronary syndrome presentations and has been increasingly recognized.1 Reverse Takotsubo cardiomyopathy, a variant form of Takotsubo cardiomyopathy has been described which presents with hyperdynamic function of the apical segments and hypokinesis of the basal or mid-ventricular segments, is the rarest type of acute stress cardiomyopathy, with mid-ventricular akinesia and preservation of apical and basal contractility.2 \u0000Case Report: \u0000We report the rare case of an elderly lady admitted to our intensive care unit (ICU) with acute respiratory failure due to exacerbation of chronic obstructive lung disease and heart failure. Echocardiography revealed reverse Takotsubo cardiomyopathy. Cardiac catheterization showed nonobstructive coronary artery disease. The wall motion abnormalities resolved in 2 weeks. The case is unique in that she had an identical presentation one year earlier after she had entered the same dusty room! \u0000Conclusion: \u0000This case demonstrates that reverse Takotsubo cardiomyopathy with identical wall motion abnormalities can recur in a patient when re-exposed to similar stressful situation. Early recognition and appropriate management can prevent catastrophic outcomes.","PeriodicalId":44017,"journal":{"name":"Galen Medical Journal","volume":"217 4","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138621090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ahmad Rastgarian, Khatereh Dehghani, Shahram Shafa, Mohammad Sadegh Sanie Jahromi, Mansour Deylami, Soha Azizi, Mohammad Zarenezhad, Kaveh Hedayati Emami, Vahid Rahmanian, Tayyebeh Zarei, Navid Kalani
background: While there are multiple guidelines for the management of bleeding complications and hematoma if being treated with antithrombotic and anticoagulant drugs, these risks are not yet stratified for procedures with regional anesthesia. Materials and Methods: This study was an umbrella review of systematic studies and meta-analysis based on PRISMA guidelines in databases of Scopus, PubMed, Medline, Cochrane Library, and Web of Science databases. Due to heterogeneity in evaluated outcomes and methods of studies, only the qualitative evidence synthesis was performed. AMSTAR checklist was used to assess the risk of bias in included systematic reviews. Results: After an extensive search of relevant studies, 971 primary cases were identified. Following a thorough screening process, 5 systematic reviews were selected. The evidence suggests that head and neck punctures generally do not result in bleeding complications, except for rare cases of hematoma associated with Infraclavicular brachial plexus block. A deep cervical plexus block is not recommended. Interscalene blocks have varying findings, with some studies reporting hematoma incidence and spinal injury, while others consider them low risk. Supraclavicular brachial plexus block might be associated with hemothorax and infraclavicular blocks are not favored by reviews. Axillary brachial plexus blocks have a minor incidence of hematoma. Abdomen blocks, TAP blocks, ilioinguinal blocks, and rectus sheath blocks carry a higher risk of hematoma. Pectoral nerve (PECS) blocks have a relatively high risk, while paravertebral and intercostal blocks are considered high risk, but further research is needed regarding paravertebral blocks. Conclusion: The available evidence from systematic reviews and studies suggests varying levels of risk for different blocks and procedures that should be considered before decision-making.
背景:虽然对于使用抗血栓和抗凝药物治疗的出血并发症和血肿的管理有多种指南,但这些风险尚未对区域麻醉手术进行分层。材料和方法:本研究是对Scopus、PubMed、Medline、Cochrane Library和Web of Science数据库中基于PRISMA指南的系统研究和荟萃分析的总称综述。由于评估结果和研究方法的异质性,仅进行了定性证据综合。AMSTAR检查表用于评估纳入系统评价的偏倚风险。结果:在广泛检索相关研究后,确定了971例原发病例。经过彻底的筛选过程,选择了5个系统评价。有证据表明,头颈部穿刺通常不会导致出血并发症,除了罕见的锁骨下臂丛神经阻滞血肿病例。不推荐深颈神经丛阻滞。斜角肌间阻滞有不同的结果,一些研究报告血肿发生率和脊髓损伤,而另一些研究认为其风险低。锁骨上臂丛阻滞可能与血胸有关,而锁骨下阻滞不受文献回顾的青睐。腋窝臂丛阻滞有轻微的血肿发生率。腹部阻滞、TAP阻滞、髂腹股沟阻滞和直肌鞘阻滞具有较高的血肿风险。胸神经阻滞的危险性较高,椎旁阻滞和肋间阻滞的危险性较高,但椎旁阻滞的危险性有待进一步研究。结论:来自系统评价和研究的现有证据表明,在决策之前应考虑不同块和程序的不同风险水平。
{"title":"Puncture site bleeding complications of peripheral nerve block in patients taking antithrombotic and anticoagulant drugs: An umbrella review","authors":"Ahmad Rastgarian, Khatereh Dehghani, Shahram Shafa, Mohammad Sadegh Sanie Jahromi, Mansour Deylami, Soha Azizi, Mohammad Zarenezhad, Kaveh Hedayati Emami, Vahid Rahmanian, Tayyebeh Zarei, Navid Kalani","doi":"10.31661/gmj.v12i.2958","DOIUrl":"https://doi.org/10.31661/gmj.v12i.2958","url":null,"abstract":"background: While there are multiple guidelines for the management of bleeding complications and hematoma if being treated with antithrombotic and anticoagulant drugs, these risks are not yet stratified for procedures with regional anesthesia. Materials and Methods: This study was an umbrella review of systematic studies and meta-analysis based on PRISMA guidelines in databases of Scopus, PubMed, Medline, Cochrane Library, and Web of Science databases. Due to heterogeneity in evaluated outcomes and methods of studies, only the qualitative evidence synthesis was performed. AMSTAR checklist was used to assess the risk of bias in included systematic reviews. Results: After an extensive search of relevant studies, 971 primary cases were identified. Following a thorough screening process, 5 systematic reviews were selected. The evidence suggests that head and neck punctures generally do not result in bleeding complications, except for rare cases of hematoma associated with Infraclavicular brachial plexus block. A deep cervical plexus block is not recommended. Interscalene blocks have varying findings, with some studies reporting hematoma incidence and spinal injury, while others consider them low risk. Supraclavicular brachial plexus block might be associated with hemothorax and infraclavicular blocks are not favored by reviews. Axillary brachial plexus blocks have a minor incidence of hematoma. Abdomen blocks, TAP blocks, ilioinguinal blocks, and rectus sheath blocks carry a higher risk of hematoma. Pectoral nerve (PECS) blocks have a relatively high risk, while paravertebral and intercostal blocks are considered high risk, but further research is needed regarding paravertebral blocks. Conclusion: The available evidence from systematic reviews and studies suggests varying levels of risk for different blocks and procedures that should be considered before decision-making.","PeriodicalId":44017,"journal":{"name":"Galen Medical Journal","volume":"115 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136070209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Appendicitis is one of the most common causes of acute abdominal surgeries. The importance of parasitic etiologies in the pathogenesis of appendicitis is not well known in appendectomy specimens on a large scale in southwestern Iran. The current study aimed to retrospectively assess the demographic data and histopathological records of appendicitis in a 28-year period in Fars province, southwestern Iran. Materials and Methods: Histopathological records of 13,013 patients who had undergone surgeries for appendicitis at Dr. Ali Shariati Hospital, affiliated with the Fasa University of Medical Sciences from December 1993 to January 2021 were reviewed and data concerning the patients' demographic data and histopathological records were retrieved from each record. More than 6800 archived microscopic glass slides were also reviewed. Results: From a total of 13,013 histopathological records of surgical excisions of appendicitis that were reviewed over a 28-year period, 8,189 (62.9%) were male and 4,842 (37.1%) were female. Patients' age ranged from 2 to 98 years, with a mean age of 24.68±19.87 years. The most common inflammatory changes were 5,687 (43.7%), 1,228 (9.4%), 670 (5.1%), 522 (4%), and 363 (2.8%) cases of acute appendicitis, suppurative appendicitis, early acute appendicitis, gangrenous appendicitis, and perforated appendicitis respectively. Microscopically, no viral inclusions, fungal elements, and histopathologic findings of bacterial causes were found. Parasitic infections such as helminthiasis were detected in 74 (0.6%) cases aged from 6 to 63. Enterobiasis (Syn. oxyuriasis, pinworm infection) accounted for 73 (98.6%) of the 74 helminthiases, while ascariasis accounted for 1 (1.4%). Out of 74 cases, 29 (39.2%) showed evidence of appendicitis. Conclusion: The results suggest that although parasitic agents are minor causes of appendicitis, these agents should be kept in mind during differential diagnosis. However, whether every parasitic infection leads to appendicitis is controversial.
背景:阑尾炎是急性腹部手术最常见的原因之一。寄生病原学在阑尾炎发病机制中的重要性在伊朗西南部大规模阑尾切除标本中尚不为人所知。本研究旨在回顾性评估伊朗西南部法尔斯省28年来阑尾炎的人口统计数据和组织病理学记录。材料和方法:回顾1993年12月至2021年1月在Fasa医科大学附属Dr. Ali Shariati医院接受阑尾炎手术的13,013例患者的组织病理学记录,并从每个记录中检索患者的人口统计数据和组织病理学记录。还审查了6800多份存档的显微玻片。结果:回顾28年来阑尾炎手术切除的13,013例组织病理学记录,男性8,189例(62.9%),女性4,842例(37.1%)。患者年龄2 ~ 98岁,平均24.68±19.87岁。急性阑尾炎、化脓性阑尾炎、早期急性阑尾炎、坏疽性阑尾炎和穿孔性阑尾炎分别为5687例(43.7%)、1228例(9.4%)、670例(5.1%)、522例(4%)和363例(2.8%)。显微镜下,未发现病毒包涵体、真菌成分和细菌引起的组织病理学结果。在6 ~ 63岁的74例(0.6%)中检出寄生虫感染,如蛔虫病。74例寄生虫病中,肠蛔虫病73例(98.6%),蛔虫病1例(1.4%)。74例患者中有29例(39.2%)表现为阑尾炎。结论:虽然寄生虫是阑尾炎的次要病因,但在鉴别诊断时应注意。然而,是否每一种寄生虫感染都会导致阑尾炎仍有争议。
{"title":"The Histopathological Findings in Appendectomy Specimens in an Iranian Population","authors":"Mahmoud Agholi, Farideh Esfandiari, Hamid Reza Heidarian, Fatemeh Khajeh, Zahra Sharafi, Ehsan Masoudi, Mohammad Rayani","doi":"10.31661/gmj.v12i.2482","DOIUrl":"https://doi.org/10.31661/gmj.v12i.2482","url":null,"abstract":"Background: Appendicitis is one of the most common causes of acute abdominal surgeries. The importance of parasitic etiologies in the pathogenesis of appendicitis is not well known in appendectomy specimens on a large scale in southwestern Iran. The current study aimed to retrospectively assess the demographic data and histopathological records of appendicitis in a 28-year period in Fars province, southwestern Iran. Materials and Methods: Histopathological records of 13,013 patients who had undergone surgeries for appendicitis at Dr. Ali Shariati Hospital, affiliated with the Fasa University of Medical Sciences from December 1993 to January 2021 were reviewed and data concerning the patients' demographic data and histopathological records were retrieved from each record. More than 6800 archived microscopic glass slides were also reviewed. Results: From a total of 13,013 histopathological records of surgical excisions of appendicitis that were reviewed over a 28-year period, 8,189 (62.9%) were male and 4,842 (37.1%) were female. Patients' age ranged from 2 to 98 years, with a mean age of 24.68±19.87 years. The most common inflammatory changes were 5,687 (43.7%), 1,228 (9.4%), 670 (5.1%), 522 (4%), and 363 (2.8%) cases of acute appendicitis, suppurative appendicitis, early acute appendicitis, gangrenous appendicitis, and perforated appendicitis respectively. Microscopically, no viral inclusions, fungal elements, and histopathologic findings of bacterial causes were found. Parasitic infections such as helminthiasis were detected in 74 (0.6%) cases aged from 6 to 63. Enterobiasis (Syn. oxyuriasis, pinworm infection) accounted for 73 (98.6%) of the 74 helminthiases, while ascariasis accounted for 1 (1.4%). Out of 74 cases, 29 (39.2%) showed evidence of appendicitis. Conclusion: The results suggest that although parasitic agents are minor causes of appendicitis, these agents should be kept in mind during differential diagnosis. However, whether every parasitic infection leads to appendicitis is controversial.","PeriodicalId":44017,"journal":{"name":"Galen Medical Journal","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135459173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Excessive inflammatory response is associated with several diseases. Recently, there has been an increasing trend for investigation of the acute or short-term effects of whey protein alone or in combination with carbohydrates on inflammatory status, especially in athletes. This systematic review aimed to clarify these effects.
Materials and methods: PubMed, Scopus, and Web of Science databases were searched from January 1990 to September 2021, without language restriction. Adult studies examining the effects of whey protein alone or together with carbohydrates on interleukin-6, tumor necrosis factor-α, and C-reactive protein levels with a maximum duration of 15 days and with at least one comparison group were included. The quality of studies was analyzed using the Cochrane risk of bias tool.
Results: Twenty-five studies met the inclusion criteria. Significant reductions in inflammatory markers was observed in seven out of 25 studies (28%). However, one out of 25 studies (4%) reported a significant increase in inflammatory status. Among those studies comparing the effects of whey protein alone with non-protein or protein-containing groups, 18.18% (two out of 11) and 10% (one out of ten) of the trials revealed a significant decrease in the markers, respectively. Moreover, of those studies comparing whey protein plus carbohydrate with non-protein or protein-containing groups, 33.33% (two out of six) and 40% (two out of five) of them showed a significant reduction in the inflammatory response, respectively. The quality of the majority of studies (84%) was poor.
Conclusion: It seems that whey protein alone or the combination of it with carbohydrates may not affect the inflammatory markers in the short run (PROSPERO registration number: CRD42021273915).[GMJ.2023;12:e2441].
背景:过度炎症反应与多种疾病有关。最近,研究乳清蛋白单独或与碳水化合物联合对炎症状态的急性或短期影响的趋势越来越多,尤其是在运动员中。本系统综述旨在阐明这些影响。材料和方法:检索PubMed、Scopus和Web of Science数据库,时间为1990年1月至2021年9月,无语言限制。包括成人研究,研究乳清蛋白单独或与碳水化合物一起对白细胞介素-6、肿瘤坏死因子和C反应蛋白水平的影响,最长持续时间为15天,至少有一个对照组。使用Cochrane偏倚风险工具对研究质量进行分析。结果:25项研究符合纳入标准。在25项研究中有7项(28%)观察到炎症标志物显著减少。然而,25项研究中有一项(4%)报告炎症状态显著增加。在比较单独乳清蛋白与非蛋白质或含蛋白质组的效果的研究中,18.18%(11个中的2个)和10%(10个中的1个)的试验分别显示标记物显著降低。此外,在将乳清蛋白加碳水化合物与非蛋白质或含蛋白质组进行比较的研究中,33.33%(六分之二)和40%(五分之两)的研究分别显示炎症反应显著降低。大多数研究(84%)的质量较差。结论:从短期来看,乳清蛋白单独或与碳水化合物联合可能不会影响炎症标志物(PROSPERO注册号:CRD42021273915)。[GMJ.2023;12:e2441]。
{"title":"Acute or Short-term Effects of Whey Protein Alone or Along with Carbohydrate on Inflammation: A Systematic Review of Clinical Trials:.","authors":"Ali Akbari, Mahsa Moazen, Siavash Babajafari, Seyedeh Maryam Abdollahzadeh, Maryam Ranjbar Zahedani, Najmeh Sasani, Asma Kazemi","doi":"10.31661/gmj.v12i.2441","DOIUrl":"10.31661/gmj.v12i.2441","url":null,"abstract":"<p><strong>Background: </strong>Excessive inflammatory response is associated with several diseases. Recently, there has been an increasing trend for investigation of the acute or short-term effects of whey protein alone or in combination with carbohydrates on inflammatory status, especially in athletes. This systematic review aimed to clarify these effects.</p><p><strong>Materials and methods: </strong>PubMed, Scopus, and Web of Science databases were searched from January 1990 to September 2021, without language restriction. Adult studies examining the effects of whey protein alone or together with carbohydrates on interleukin-6, tumor necrosis factor-α, and C-reactive protein levels with a maximum duration of 15 days and with at least one comparison group were included. The quality of studies was analyzed using the Cochrane risk of bias tool.</p><p><strong>Results: </strong>Twenty-five studies met the inclusion criteria. Significant reductions in inflammatory markers was observed in seven out of 25 studies (28%). However, one out of 25 studies (4%) reported a significant increase in inflammatory status. Among those studies comparing the effects of whey protein alone with non-protein or protein-containing groups, 18.18% (two out of 11) and 10% (one out of ten) of the trials revealed a significant decrease in the markers, respectively. Moreover, of those studies comparing whey protein plus carbohydrate with non-protein or protein-containing groups, 33.33% (two out of six) and 40% (two out of five) of them showed a significant reduction in the inflammatory response, respectively. The quality of the majority of studies (84%) was poor.</p><p><strong>Conclusion: </strong>It seems that whey protein alone or the combination of it with carbohydrates may not affect the inflammatory markers in the short run (PROSPERO registration number: CRD42021273915).[GMJ.2023;12:e2441].</p>","PeriodicalId":44017,"journal":{"name":"Galen Medical Journal","volume":"12 ","pages":"e2441"},"PeriodicalIF":0.5,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10506851/pdf/GMJ-12-e2441.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41143155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The prevalence of pre-menopausal female infertility is increasing considerably due to various causes such as environmental pollutants, increased administration of chemotherapeutics and radiation exposure, microbial infections, and genetic/epigenetic alterations. However, the current therapeutical strategies remain unfavorite as the disadvantages are strongly challenging. Icariin (ICI) is a phytoestrogen that exerts some promising properties in order to alleviate female infertility. Therefore, the current literature review aimed to evaluate the conducted studies regarding the beneficial impacts of ICI on the female reproductive system and female fecundity. The findings of the present study revealed that ICI is able to modulate the levels of reproductive hormones as it causes a significant decrement in the levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) while increasing the levels of estrogen and progesterone. Furthermore, the administration of ICI results in a dramatic alteration in the expression of sex steroids’ receptors, particularly in female reproductive tissues. In addition, preserving ovarian follicular reserve, improving the ovarian and uterine histoarchitecture, elongating the estrous cycle duration, and eventually advancing the female fecundity are other major effects of ICI on the female reproductive system. Despite these desired beneficial properties, the current knowledge appears to be insufficient, hence further investigations, particularly on humans, are encouraged. To the best of our knowledge, this review provides a comprehensive information regarding the beneficial effects of Icariin on female infertility for the firs time.
{"title":"Icariin, A Novel Promising Complementary Therapeutic Strategy in the Management of Female Infertility: A Literature Review:.","authors":"Sima Mosavi, Amirabbas Rostami, Marzieh Pooladi, Mahdie ShojaeiBaghini, Sahar Poudineh, Maryam Poudineh, Esmaeil Behzadi","doi":"10.31661/gmj.v12i.2528","DOIUrl":"10.31661/gmj.v12i.2528","url":null,"abstract":"<p><p>The prevalence of pre-menopausal female infertility is increasing considerably due to various causes such as environmental pollutants, increased administration of chemotherapeutics and radiation exposure, microbial infections, and genetic/epigenetic alterations. However, the current therapeutical strategies remain unfavorite as the disadvantages are strongly challenging. Icariin (ICI) is a phytoestrogen that exerts some promising properties in order to alleviate female infertility. Therefore, the current literature review aimed to evaluate the conducted studies regarding the beneficial impacts of ICI on the female reproductive system and female fecundity. The findings of the present study revealed that ICI is able to modulate the levels of reproductive hormones as it causes a significant decrement in the levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) while increasing the levels of estrogen and progesterone. Furthermore, the administration of ICI results in a dramatic alteration in the expression of sex steroids’ receptors, particularly in female reproductive tissues. In addition, preserving ovarian follicular reserve, improving the ovarian and uterine histoarchitecture, elongating the estrous cycle duration, and eventually advancing the female fecundity are other major effects of ICI on the female reproductive system. Despite these desired beneficial properties, the current knowledge appears to be insufficient, hence further investigations, particularly on humans, are encouraged. To the best of our knowledge, this review provides a comprehensive information regarding the beneficial effects of Icariin on female infertility for the firs time.</p>","PeriodicalId":44017,"journal":{"name":"Galen Medical Journal","volume":"12 ","pages":"e2528"},"PeriodicalIF":0.5,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10497255/pdf/GMJ-12-e2528.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10296080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}