Jorjani Biomedicine Journal

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Background and objective:

Delirium is an acute and transient disorder in the function of the brain. Although the main core of this syndrome is consciousness disorder and deficiencies in attention and concentration, the general deficiency is seen in all psychological areas of thinking, temperament, cognition, language, speaking, sleeping, and mental-motional and other cognitive areas. Delirium is often seen in recovery room and is a predictor of post-operative delirium in the general ward. This study was conducted to determine the incidence of delirium in patients after surgery in the recovery room.

Materials and Methods:

This descriptive cross-sectional study was conducted on 75 patients after general and orthopedic surgery and in the recovery room of the educational-therapeutic center of Gorgan in 1389 using the DESC-Nu nursing delirium screening scale. Data was analyzed using chi-square descriptive and analytical statistics and T-test.

Results:

Among the 75 studied patients in the recovery room after orthopedic surgery and general surgery, 53.3% were women with a mean age of 48.7. The mean surgery duration was 129.21 minutes. 26.6% had been under spinal anesthesia and 73.3% had been under general anesthesia. Delirium was observed in 30.6% of all the patients. Delirium was observed in 21.3% of patients having orthopedic surgery and 9.3% of the patients having general surgery. Delirium had a significant statistical relation with the variables of age, gender, and type of surgery (p<0.05).

Conclusion:

This study showed that 30.6% of patients had delirium. Male and older patients having orthopedic surgery were more vulnerable. Therefore, usual assessment of delirium in recovery room to identify patients with delirium can be a guide of nurses’ appropriate care of patients after surgery.

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Background and Objectives: Human papilloma virus (HPV) is known as the etiologic agent of cervical cancer and second common cancer among women. HPV viruses with the elevated risk of infection have more potentiality to cause cancer. The carcinogenesis in these viruses is accomplished by oncoproteins such as E7. Employing DNA vaccines which code specific antigens such as E7 is a novel therapeutic approach against such cancers.

Methods: In the present study, plasmid coding HPV16 E7 was administered intracutaneously to C57BL/6 tumoric mice models for investigation of its immunostimulating potential. PcDNA3.1+ vector was used as control vector. After immunization, spleen of animals were removed. Then, release of lactate dehydrogenase (LDH) was evaluated to address the cytotoxic activity (CTL) induced by cellular immunity in spleenocytes. Interferon-γ (IFN-γ) and interleukin-4 (IL-4) cytokines were also analyzed as profiles of Th1 and Th2, respectively. Anti-inflammatory cytokine interleukin-10 (IL-10) levels were also investigated in tumor microenvironments.

Results: Our results showed that CTL activity was higher among samples receiving HPV16 E7 coding vector in comparison to the group receiving pcDNA3.1+ control vector (P < 0.05). Levels of IFN-γ and IL-4 were also higher in the group receiving HPV16 E7 plasmid in comparison to the control group (P < 0.05). Similarly, IL-10 levels were significantly lower in tumor carrying mice groups receiving HPV16 DNA vaccine compare to PBS and pcDNA3.1 receiving control groups.

Conclusion: HPV16 E7 expressing DNA vaccine could increase the release of LDH due to immune system CTL activity. Elevation in IFN-γ and IL-4 levels as well as IL-10 reduction indicates an increase in both Th1 and Th2 profiles resulted by using potent DNA vaccine coding HPV16 E7 in tumor animal model.

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Study objectives: Rheumatoid arthritis (RA) is a common chronic and systemic autoimmune disease, characterized by inflammation and the destruction of the joints. It is well known that CD4+ T cells play a major role in the pathogenesis of RA. Expanded subpopulations of CD4+ T cells have been reported in RA patients. Here, we investigated the expression of PD-1 on subsets of CD4+ T cells (CD4+CD28- and CD4+CD28+ T cells) in the peripheral blood (PB) and synovial fluid (SF) of patients with RA.
Methods: A total of 42 RA patients, including 10 newly diagnosed (ND) and 32 relapsed (RL) cases and also 20 healthy controls were enrolled. Phenotypic characterization subsets of CD4+ T cells were evaluated by flow cytometry, using fluorescence conjugated specific human monoclonal antibodies.
Results: The frequency of CD4+CD28+ T cells was significantly increased in SF versus PB in ND and RL patients. In contrast, the percentage of CD4+CD28- T cells was elevated in PB of ND and RL patients comparison to SF. Expression of PD-1 on CD4+CD28+ and CD4+CD28- T cells in PB of ND and RL patients was significantly higher than the healthy controls. Furthermore, PD-1 expression on CD4+CD28+ and CD4+CD28- T cells in SF versus PB of RL patients were significant increased.
Conclusion: These data suggest that CD4+ T cells subsets in RA patients were resistance to PD-1 mediated effects and PD-1 has insufficient ability to suppression of CD4+T cells.