This study showed that factors such as primary clinical signs, stage of primary tumor, and adjacent organ involvement are significant with respect to the time for recurrence of colorectal cancer. It is important to take these characteristics into account in patient care management after curative resection for colorectal cancer.
Breast pain is a complex symptom that can be relieved significantly with reassurance. According to the result of this study, naproxen has no superiority over placebo in reducing noncyclic breast pain.
Background: Cyclo-oxygenase-2 (COX-2), an enzyme induced in pathological states, mediates the production of prostaglandins. Celecoxib as a selective COX-2 inhibitor may affect the outcome of treatments in several cancer types. Objectives: We conducted a randomized controlled double-blind clinical trial to evaluate the toxicity and efficacy of celecoxib administered concurrently with chemoradiation in locally advanced head and neck carcinomas. Methods: Patients with locally advanced head and neck carcinoma referred for definitive chemoradiation were eligible to enter the study. Celecoxib (100mg, qid, oral) or placebo was administered all over the chemoradiation period. Results: Totally, 122 patients were enrolled. Patients in the celecoxib group had a longer median time to onset of grade 2 mucositis (56 days vs. 28 days, P < 0.001) and a lower rate of grade 3 mucositis (1.6% vs. 21.3%, P = 0.001). The 4-year progression-free survival was significantly higher in the celecoxib group (P = 0.0013). Conclusions: This study revealed that utilizing celecoxib may lead to better tumor local control and delayed and reduced mucosal side effects of chemoradiation.
Introduction. Intractable diarrhea of infancy (IDI) includes several types of early onset diarrhea; one of the rare etiologies is trichohepatoenteric (THE) syndrome, also known as syndromic diarrhea (SD) which was primarily described by Stankler et al. Hereby we report a family with several affected members which to our knowledge is the first case report from Iran. Report of Cases. A three-year-old boy referred with short stature, poor weight gain, and intermittent steatotic diarrhea to our center. He was born to healthy, relative parents (cousins). He did not gain any weight after four months of age and began having intermittent steatotic diarrhea, abdominal distension, and fever. He was hospitalized several times. Two other children in the family also showed somewhat similar symptoms. Two sweat tests were negative for cystic fibrosis. Workup for Celiac disease was performed several times which was negative; however, gluten-free diet was tried several times which was not effective. Workup for Hirschsprung's disease was performed but colon was ganglionic. Evidence of liver involvement was approved by elevated liver enzymes and coarse echo of liver on sonography. Discussion. Trichoenterohepatic syndrome should be put in mind in cases of intractable diarrhea presenting in a family with several affected members. Early diagnosis would save patients from unnecessary workups.
Background: Brain damage and mental retardation in children can be caused by either excess or depletion of certain amino acids. Up to now there is no reliable reference interval for free plasma amino acid in Iranian children. Objectives: The aim of this study was to provide the reference intervals of free plasma amino acid in healthy Iranian children using high performance liquid chromatography (HPLC) as an accurate method. Methods: 133 children referred to Children's Medical Center, Tehran, Iran for the annual checkup entered the study after filling out the informed consent form. Demographic data and blood samples after overnight fasting were collected. Plasma amino acid concentrations were determined by reverse phase HPLC (RP-HPLC) equipped with a fluorescence detector after precolumn derivatization of amino acids with o-phthalaldehyde (OPA). Results: Female children exhibited significantly higher plasma concentrations of taurine and lysine than male children. Other 20 amino acid values were not significantly different between two gender groups. Positive correlation was obsereved between age and taurine, leucine and lysine. Conclusions: Our data provided reference intervals of free plasma amino acids in healthy Iranian children. We believe our data can be used as a guideline for pediatricians to identify the significantly deviated amino acid values in children with medical issues such as genetic disorders and some acquired illnesses. Our data is also applicable for further investigations in the field of family medicine.
Background: The study aimed to investigate the out-of-range cuff pressure of endotracheal tube in mechanically ventilated patients.
Methodology: This cross-sectional study was performed in Semnan, Iran in 2019. The cuff pressure was measured in patients aged over 18 years who were intubated for at least 24 hours. Out-of-range pressure was defined as a pressure of < 20 cmH2O or > 30 cmH2O. A multiple logistic regression model was used for analysis.
Results: Of 222 cases, 67 (30.2%) had cuff pressure in the normal range and 155 (69.8%) were not in the normal range; 41 (18.5%) and 114 (51.4%) had low and high pressures. The two groups were not significantly different in terms of age and gender. Longer mechanical ventilation (p = 0.004) and hospitalization place (p = 0.001) were the two factors that had a relationship with the out-of-range pressure. The probability of out-of-range pressure was significantly higher in the cardiac (p = 0.001, OR = 6.91) and internal medicine (p = 0.008, OR = 4.61), compared to the emergency intensive care unit.
Conclusion: The authorities should take into consideration some important factors, such as the lack of instructions in hospital units, lack of proficiency for correct measurement, deficient required facilities, and not using the facilities for regular monitoring.
Keywords: Mechanical Ventilation, Endotracheal Intubation, Airway Management, Pressure.
Citation: Hemmati H, Izadi S, Soltani S, Aghamohammadlou F, Mirmohammadkhani M. Prevalence and predictors of an out-of-range cuff pressure of endotracheal tube in mechanically ventilated patients in a teaching hospital in Iran. Anaesth. pain intensive care 2020;24(5):
Received: 20 June 2020, Reviewed: 24, 28 June 2020, Accepted: 1 July 2020
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