مجله علوم پزشکی صدرا
سال نهم شماره 4 (پاییز 1400)

Cardiac Na+ channels are responsible for the excitation of the cardiac cells. Hyperglycemia is the chief symptom of diabetes and several other complications. Although many studies have been conducted on diabetic cardiomyopathy, the role of high glucose on sodium current has not been completely clarified. In the present study, the authors investigated the role of high glucose concentration on human cardiac sodium channels current in transfected HEK293 cells.

The authors evaluatedglucose effects on sodium current using the whole-cell patch-clamp technique.

The data indicated that Na+ current was significantly modified with an overnight exposure to high glucose. For steady-state activation, high glucose-induced insignificant hyperpolarizing shifted the V1/2. Steady-state inactivation shifted to more negative potentials with glucose exposure (p < 0.001).

Data suggested that the glucose effect on two forms of sodium channel gates (activation and inactivation) raises the possibility of metabolic modulations of sodium channel activity. A hyperpolarized shift of activation and inactivation is supposed to enhance cardiac cell excitability.

Fungal infections are a major concern in immunocompromised patients, such as patients with hematologic malignancies and bone marrow transplants. Opportunistic infections such as invasive fungal infections can lead to poor outcomes and a high probability of death in such patients. Gold standard methods of fungi detection are intrusive and time-consuming. Therefore, they may not be the method of choice to detect such infections rapidly; however, they are always mandatory. Next to gold-standard methods, serologic methods are rapid and non-invasive methods that have been approved for use as an adjunct to classic methods for quicker detection of fungal infections.

In this study, 68 patients diagnosed with hematologic malignancies and suspicious of fungal infection were enrolled to detect fungi with serologic testing of Beta D-Glucan using ELISA. The authors evaluated the association of malignancy type, clinical signs, and patients’ para-clinical data with positive Beta D-Glucan tests.

Out of 43 men and 25 women participating in this study, 79% had positive test results.

There was no significant association between malignancy type, clinical signs, patients’ para-clinical data, and their positive serology tests. Considering the probable false-positive results due to infection and the use of certain antibiotics in such immunocompromised patients, the authors concluded that the Beta D-Glucan ELISA test might not be a sensitive diagnosis means to diagnose fungal infections in patients with hematologic malignancies.

Breast cancer is one of the most common invasive cancers being the leading cause of mortality among women all around the world. Although the increasing trend of the geriatric population with cancer is indicative of good advances in cancer early detection and treatment, since most studies have been conducted on  younger age group, it can be said that the principles of treatment in geriatric patients remains unclear due to the vagueness of prognostic factors in this age group.

This study was conducted using the data obtained from Shiraz Breast Cancer Registry, the largest breast cancer registry in Iran. The study population included women aged 70 years and over who had breast cancer. Prognostic factors, treatment modalities, and patients’ survival rate were reviewed and investigated.

427 patients were included in this study. The mean age of patients was 75 years old +/- 5.2yrs. Invasive ductal carcinoma  (73.3%),  Grade 2 tumor (56.9 %), and size 2-5cm (50.6%) were the most common histopathological type, respectively. 81.9% of the patients were positive for estrogen receptor. 47.5% of the patients underwent quadrantectomy. 50.8% received adjuvant chemotherapy and 41.1% received adjuvant radiotherapy. The overall survival rate for women for more than 5 years (60 months) was 68% and disease-free survival rate for more than 5 years was 51%.

According to ISGO recommendation to improve breast cancer survival in the elderly, in addition to the need for more critical reappraisal in breast cancer management in this age group by clinicians, the involvement of geriatricians is needed to appraise the patients’ general condition in this age group in order to meet the treatment guidelines requirements.

Hemodialysis serves as a therapy for patients with kidney malfunction. Kidney malfunction results in the accumulation of toxins and excess fluid in the body, leading to the patient’s death if not removed. Hemodialysis adequacy can be quantified by analyzing dialysate conductivity at the dialyzer inlet and outlet.

In this paper, the authors presented a non-invasive and low-cost monitoring system of hemodialysis adequacy, which can continuously measure the conductivity of soluble in dialysis machines, allowing the delivery of more acceptable treatment.

An online measurement indicated that the presented system could easily show ionic dialysance and the patient's plasma conductivity at two different parts of the dialysate route. This technique can be an effective way to decide about terminating the dialysis according to plasma sodium concentration. The proposed system can be used as an easy-to-use impedance spectroscopy system to measure the patient's plasma conductivity on a dialysis machine. The designed system was tested and validated experimentally in actual dialysis sessions. This technique does not require any disposables or reagents, reducing patient anxiety and cost by decreasing blood sampling and laboratory analysis.

The operation and development of this system on dialysis machines will effectively prevent dialysis-induced complications.

The nurse's knowledge and skills in caring for endotracheal tube cuff pressure can lead to complications in the patient. However, few studies are available in this area. Therefore, this study aimed to determine the knowledge and practice of nurses on how to measure and control cuff pressure of patients admitted to intensive care units.

This descriptive study was performed on 151 qualified nurses working in ICU wards of Shiraz teaching hospitals in 2017. Data collection was performed using a researcher-made checklist.

21.5% of the nurses knew the normal tracheal cuff pressure and tracheostomy range. Regarding the different ways of measuring cuff pressure, 5.3% referred to the minimum leakage method, 86.7% to the manual method, 74.7% to the manometer, and no reference was made to the obstruction method. 60.7% used the manual method to measure cuff pressure, and only 39.3% used a manometer. 3.3% did not know the time interval of cuff pressure measurement. 40% in each shift, and 56.7% stated every 24 hours as the appropriate time to control it.

The results of the present study showed that the performance of nurses concerning the ways of measuring cuff pressure is appropriate. However, the nurses' knowledge in this study is limited about the normal range of endotracheal tube cuff pressure and the complications caused by the abnormal low cuff range.

A desirable and trusted organizational climate can provide a ground for creating a learning organization. This study aimed to determine the relationship between organizational climate and organizational learning in psychiatric hospitals of Shiraz.

This cross-sectional study was conducted in Shiraz Psychiatric Hospitals in 2020. The study's statistical population included 179 nurses in the mentioned hospitals who participated in the study by the census. Data were collected through standard Sussmaan and Deep organizational climate and Gomez organizational learning questionnaires and analyzed by t-test, ANOVA, Pearson correlation coefficient, and Multivariate linear regression in SPSS software, version 23.

The participants' mean age and work experience were 34.94 ± 8.44 and 11.82 ± 6.84 years, respectively.According to nurses' perception, there was a positive and significant correlation between organizational learning and organizational learning (p < sub>=0.001, r=0.548). Effective communication (p < 0.001, B=0.442, t=4.698), clarity of objectives (P=0.002, B=0.157, t=1.712) and agreement on procedures (P=0.003, B=0.128, t=1.471), which are among organizational climate dimensions, were identified as organizational learning predictors. This study showed a significant statistical relationship between organizational climate with age and work experience and organizational learning with age and education variables (p < 0.05).

Considering the correlation between climate and organizational learning, the predictive role of the three components of effective communication, clarity of goals, and agreement on procedures, hospitals can create a learning organization.

The present study aimed to identify and prioritize challenges and factors affecting the performance-based payment system for university hospitals’ staff.

The present study is a quantitative study conducted in 1400 at Lorestan University of Medical Sciences. The statistical population included 1300 people, and the sample using Cochran's formula was 589 medical and staff departments employees. All participants signed informed consent. The authors used a 40-item standardized questionnaire to collect data. They used SPSS software, version 21, to analyze data through the Kolmogorov-Smirnov test, paired and independent sample t-test, Pearson Product Moment Correlation, heuristic factor analysis, structural equation testing, and Confirmatory factor analysis to check the normality of data distribution and answer the research questions.

After exploratory analysis, eleven dimensions, including "job satisfaction, teamwork, job security, interaction with officials, individual factors, quality of life, management and control, motivation and desire, job commitment, organizational variable, and fairness in payment" were identified and approved. The quality of life as one of the dimensions with an average of 78 has the most significant impact on persons' performance.

Numerous factors affect the payment system based on the performance of university hospital staff. The quality of life has the most significant impact on realizing the payment system.

Multiple Sclerosis (MS) is an autoimmune disease of the central nervous system that destroys the immune system of normal cells in the body, resulting in abnormal progressive neuronal function. Multiple wounds (called plaques) are described as plaques in the white matter of the brain and spinal cord of MS patients. The destruction of nerve cells in the brain can cause many symptoms in MS patients, including fatigue, blurred vision in the eye, numbness in some parts of the body, partial weakness, and loss of body coordination. Apart from being genetically susceptible to MS disease, the researchers believe that at least one or more environmental factors should occur for the emergence of MS disease. The prevalence of the disease varies in different parts of the world, and the incidence and prevalence are higher in some parts of Western Europe and North America than in other parts of the world. Regulatory T cells play an essential role in preventing autoimmune diseases. Therefore, when these cells' number or function increases or decreases, it can affect autoimmunity, as these cells’ defects have been reported in many autoimmune diseases. Therefore, the use of biological systems for understanding neurological disorders is highly valued, considering time as a critical factor in developing the pathogenesis of these diseases. Research has shown that microRNAs play an essential role in multiple sclerosis because they are abundantly expressed in immune cells, which mediate MS disease. It is hoped that more extensive research will contribute to a better understanding of the mechanisms underlying MS disease, providing strategies to improve or reduce the symptoms of the MS disease.