مجله دانشکده پزشکی اصفهان
پیاپی 651 (هفته سوم بهمن 1400)

One of the problems of the treatment system is the high mortality and length stay of patients in the intensive care unit (ICU), which has high costs. The aim of this study was to determine the effect of adjustment of positive end-expiratory pressure (PEEP) and fraction of inspired oxygen (FiO2) based on PaO2 on the care and treatment outcomes of ICU patients.

This was a randomized clinical trial study in which the statistical population consisted of all patients admitted to the ICU of Imam Khomeini hospital in Ahvaz, Iran, in the second half of 2020. 40 samples were selected based on available sampling method, and randomly divided into two groups of intervention and control. To collect the data, a demographic information questionnaire as well as Sequential Organ Failure Assessment (SOFA) scoring system were used. In the intervention group, adjustment of PEEP and FiO2 was performed based on PaO2 of patients in 7 days.

There was no difference between the two groups in terms of demographic variables. The mean scores of disease severity before intervention in the two groups were not statistically different; but after the intervention, disease severity score, duration of ventilator connection, and length of ICU stay were significantly lower in the intervention group.

The adjustment of PEEP and FiO2 based on PaO2 is effective in reducing the disease severity score, duration of ventilator connection, and ICU stay. It should be used as a nursing intervention in coordination with treatment team to reduce the consequences of hospitalization in ICU.

Idiopathic short stature is a common cause for referral to children's endocrinology clinics. Despite the normal level of growth hormone, the level of insulin-like growth factor 1 (IGF-1) is low in some of these individuals, which is not well-defined. The aim of this study was to determine the effect of vitamin D on the level of IGF-1 in children aged 5 to 10 years with idiopathic stunting.

In a clinical trial study, 30 children aged 5-10 years with the diagnosis of idiopathic short stature were selected, and treated with 50000 vitamin D3 supplements every week for 8 weeks. Serum levels of vitamin D and IGF-1 were measured before and after intervention and compared.

Before and after intervention, mean serum levels of vitamin D were 17.03 ± 6.8 and 44.4 ± 9.2 ng/ml (P < 0.001), and mean serum level of IGF-1 were 17.9 ± 81.5 and 124.4 ± 37.4 ng/ml (P < 0.001), respectively. The level of IGF-1 significantly increased by vitamin D supplementation.

The present study showed that improvement of vitamin D deficiency led to increased level of IGF-1. It seems that in children with idiopathic short stature, the elimination of vitamin D deficiency can be effective in increased level of IGF-1.

The anti-inflammatory effects of exercise in chronic diseases are mediated by a decrease in pro-inflammatory cytokines and an increase in anti-inflammatory cytokines. The Aim of this study was to evaluate the effect of 4 weeks of voluntary aerobic activity along with interferon beta on the serum levels of tumor necrosis factor alfa (TNF-α) and interleukin 10 (IL-10) in mice model of multiple sclerosis.

In this experimental study, a total number of 80 female mice were divided into eight groups. To induce of Experimental Autoimmune Encephalomyelitis (EAE), mixture of myelin oligodendrocyte glycoprotein (MOG) (35-55) was injected subcutaneously, and pertussis toxin was injected intraperitoneally. The interferon beta drug protocol in amount of 150 IU/g as well as the 4-week protocol of voluntary aerobic exercise with running wheel were administered to the treatment groups. Finally, blood samples were taken from the heart and data analysis was done using one-way ANOVA test.

TNF-α levels in the MS+INF-β group significantly reduced compared to the MS + solvent group (P = 0.0010), and a significant increase was observed in the amount of IL-10 in comparison with the same groups (P = 0.01). But aerobic activity along with interferon beta-1 treatment, more effectively led to an increase in IL-10 of serum and a decrease in serum TNF-α in MS + INF-β + running wheel group compared to MS + solvent + running wheel group (compared to exercise or medication alone) (P = 0.001).

Aerobic activity along with medication may possibly lead to clinical improvement and quality of life in patients with MS by controlling inflammatory factors.