Advanced Biomedical Research最新文献

Background: Endotracheal intubation is employed to create a safe airway in patients requiring mechanical ventilation. The relatively high prevalence rate of unplanned displacement of the endotracheal tube (ETT) can be associated with serious complications. This study was conducted to evaluate the effectiveness of a newly designed tube holder in Iran (Irafit), the Thomas ETT holder and the traditional method using adhesive tape.

Materials and methods: The present manikin-based study was performed on the human mannequin. For this purpose, the mannequin was first subjected to oral intubation by a skilled emergency medicine specialist. Then, three methods of adhesive tape, Irafit-ETT holder, and Thomas-ETT holder were used. The mean of displacement in width of the mouth, length of the ETT, and depth as well as ETT removal was recorded.

Results: The results of the present study revealed that the displacement in depth was significantly less in the Irafit-ETT holder as compared with the other two groups following the application of a tug (P < 0.001). The displacement in the length of the ETT with and without the application of a tug was significantly less in the Irafit-ETT holder and Thomas-ETT holder groups as compared with the adhesive tape group (P < 0.001).

Conclusion: According to the results of the present study, it can be stated that both ETT holder devices (Thomas vs. Irafit) were not distinct in terms of displacements in length and width; however, the Iranian model was more successful in minimizing the displacement in depth.

Background: Different techniques have been introduced to reduce the complications of nasotracheal intubation. The aim of this study was to compare the incidence of nasotracheal intubation complications in finger-guided and conventional methods.

Materials and methods: In this double-blind randomized trial study, 70 patients who were candidates for oral and maxillofacial surgery who required nasal intubation were included in the study finally of which 33 patients with conventional method and 35 patients with finger-guided tubes in the nasopharynx were analyzed at the end of the study. Variables such as success rate, hemodynamic response, and complications of intubation were compared between the two groups.

Results: There was no significant difference between the two groups in terms of hemodynamic response to intubation (P > 0.05). There was a significant difference between the two groups in terms of success in tracheal intubation (P < 0.05). There was a significant difference between the two groups in terms of epistaxis immediately after intubation (P < 0.05). There was no significant difference between the two groups in terms of nasal turbine fractures (P > 0.05). However, the frequency of submucosal intubation in the conventional method was significantly higher than the other group (P = 0.02).

Conclusion: Nasotracheal intubation using the finger guiding technique in the nasopharynx is associated with a higher success rate and less complications after intubation such as epistaxis and submucosal intubation compared to the conventional method.

Background: Chorionic villus sampling (CVS) is one of the invasive diagnostic methods used to diagnose chromosomal, genetic, and metabolic diseases in the embryonic period. The use of this method is associated with maternal and fetal consequences, the most serious of which is abortion. Therefore, the present study was conducted to investigate the incidence of these consequences and the factors affecting the incidence of abortion.

Materials and methods: A cross-sectional study was performed on 98 pregnant women with CVS indications. Maternal and fetal outcomes including abortion, vaginal bleeding, subchorionic hematoma, premature rupture of membrane (PROM), chorioamnionitis, preterm delivery, limb abnormality, fetal growth retardation, and preeclampsia were recorded.

Results: The results of the present study showed that the incidence of fetal outcomes including fetal growth failure, premature rupture of membranes, abortion, and limb abnormalities was 4.1%, 7.1%, 3.1%, and 1%, and the incidence of maternal outcomes including preterm delivery, subchorionic hematoma, preeclampsia, and hemorrhage was 14.3%, 3.1%, 6.1%, and 10.2%, respectively. In addition, a decrease in free BHCG and an increase in NT were significantly associated with the occurrence of abortion (OR: 0.11 and 4.25, respectively, P value < 0.05).

Conclusion: It should be noted that due to a long time between placental sampling and the occurrence of vaginal bleeding, premature rupture of membrane, and preterm delivery, it seems that placental sampling has no effect. In addition, only a decrease in free BHCG or an increase in NT significantly increased the chance of miscarriage.

Background: In the current study, we aimed to evaluate the association between pregnancy-related plasma protein-A (PAPP-A) levels measured in the first trimester and pregnancy outcomes.

Materials and methods: This is a descriptive-analytical study that was performed in 2019--2021 on 1061 pregnant women in their first trimester. Demographic and basic information of all women were collected. These data included age, weight, parity, and date of delivery. Then the quantity of PAPP-A was recorded in three groups including less than 0.5 MOM, 0.5 to 2.5 MOM, and more than 2.5 MOM.

Results: Data of 1061 women were analyzed. 900 women (84.8%) had term delivery and 155 women (14.6%) had pre-term deliveries. PAPP-A levels were normal in 83.4% of women. BMI and number of pregnancies had significant relationships with PAPP-A (p < 0.001, P = 0.03 respectively). The mean BMI in mothers with PAPP-A higher than 2.5 was significantly more than mothers with normal or lower PAPP-A levels (26.2 ± 31, P = 0.04). The frequency of term labor in mothers with normal PAPP-A was higher than other mothers (86.3%, P = 0.04). The frequency of preeclampsia in recent pregnancies in mothers with normal PAPP-A was significantly lower than other mothers (p < 0.001) and the frequency of abortions in recent pregnancies in mothers with PAPP-A less than 0.5 was significantly higher than mothers with normal or elevated PAPP-A (p < 0.001).

Conclusion: Mothers with low PAPP-A levels are more likely to have poor pregnancy outcomes such as abortion, pre-term labor, and preeclampsia.

Background: The surgery for a breast imaging-reporting and data system (BIRADS) IV lesions needs imaging or pathology supporting data. The roll of breast scintigraphy for this purpose is unclear.

Materials and methods: In a prospective design, 16 patients with 25 BIRADS IV lesions who were scheduled for surgery were included. Before the surgery, breast scintigraphy was done using a nondedicated dual head gamma camera in the prone position employing a shaped foam pad providing imaging at breast pendulous position. Twenty mCi^99m Tc methoxy-isobutyl-isonitrile was injected and two 15 and 60-min delayed imaging were done (anterior, bilateral, and single photon emission computed tomography [SPECT] projections). Pathology reports were collected and tumor to nontumor uptake ratio (T/NT) was analyzed, accordingly.

Results: Out of all lesions, 12 were malignant (invasive ductal and lobular carcinoma ductal carcinoma in situ). At 15 min, T/NT was insignificantly higher in the malignant compared to benign lesions (22.8 ± 23.9 vs. 10.1 ± 10.1; P = 0.109). The optimal T/NT cutoff for discrimination of malignant and benign lesions was 20. Only 1 out of 13 benign lesions presented uptake >20 (7.7%; false-positive rate; P = 0.047). The diagnostic accuracy, sensitivity, and specificity for T/NT calculated at 0.68, 0.42, and 0.92, respectively. The T/NT at 60 min remained unchanged for either benign or malignant lesions (22.3 ± 30.2 vs. 11.7 ± 17.1; P = 0.296).

Conclusions: Breast scintigraphy with general purpose gamma camera employing SPECT imaging may assist the selection of BIRADS IV lesions in need for surgery. All uptake positive cases should undergo surgery and decision for uptake negative cases should be made based on other data.

Background: The new coronavirus is an agent of respiratory infections associated with thrombosis in vital organs. This study aimed to propose a better diagnosis and treatment of coagulation disorders caused by the new coronavirus (Covid-19).

Materials and methods: Search in Cochrane central, Web of Science, PubMed, Scopus, and Ovid will be done. Also, according to the inclusion criteria, cross-sectional studies, cohort, clinical trial, and case-control will be included without gender and language restriction. Participants will also be Covid-19 patients with coagulation disorders. Any disagreement in the stages of screening, selection, and extraction of data between the two reviewers will be resolved by discussion, then if not resolved, the opinion of expert reviewers will be used. The risk of bias will be assessed using the NOS (Newcastle-Ottawa scale) tool for cross-sectional study, cohort and case-control, and the Cochrane checklist for clinical trials study. Metaanalysis of included studies that are similar based on the methodology will be done. Also, a fixed or random-effect model will be used for this it. Heterogeneity indices (I2), odds ratio (OR), risk ratio (RR), mean difference, and %95 confidence interval will also be calculated by Stata V.13.0 (Corporation, College Station TX).

Results: Treatment with anticoagulants will reduce the severity of thrombosis and lung disease in patients. D-dimer measurement will also be a diagnosis indicator of thrombosis.

Conclusions: Simultaneous study of coagulation disorders and thrombosis in patients and development of a Godliness based on it will play a treatment role in the follow-up of the coronavirus disease.

Primary central nervous system lymphoma (PCNSL) is uncommon with scarce cases having involvement of the spinal cord. Cauda equina is unique in its location and shows very rare involvement by diseases pathologies. When the same occur, they pose a lot of diagnostic difficulties as the location is difficult to access with overlapping radiologic abnormalities. It is an unusual location for lymphomas to occur with only few cases reported in literature. The cauda equina lymphomas may mimic other entities which occur at that site. Histopathology is the gold standard for the same. Here, we report an unusual case of cauda equina lymphoma mimicking a myxopapillary ependymoma in a 50-year-old male.