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1.  The Impact of Evidence-Based Practices on Postoperative Pain in Patients undergoing Gastrointestinal Surgery in Amiralmomenin Hospital in Zabol During 2014-2015 
The Evidence-Based Practices (EBP), have gained considerable ground in treatment and care, increases the quality of nurses’ clinical care. Yet EBP is less frequently employed despite its efficiency and importance. Pain management is an important component of nursing care and sufficient pain control has still remained as a challenge despite routine nursing practices that are already provided.
The present study intended to define the impact of evidence-based nursing practices on postoperative pain in patients undergoing gastrointestinal surgery.
Materials and Methods
The present study was a single group quasi-experimental study with before/after design. The study was conducted in the General Surgery Departments of the Amiralmomenin Hospital in Zabol during 2014-2015. A purposive sampling method was used to study 55 patients undergoing abdominal surgery. The data collection tool was a questionnaire. The patients pain severity was defined before and after implementing evidence-based practices. The collected data were analysed in SPSS using descriptive statistics and inferential statistics.
The results showed that 61.8% of patients experienced severe postoperative pain. The mean perceived pain ratings in women and men were 7.88±1.78 and 9.42±0.81, respectively. The mean pain intensity was 8.48±1.66 before the intervention and reached 7.16±1.71 after the intervention, which was significant based on Kruskal-Wallis test (p=0.003). The mean postoperative pain experienced by the patients (p<0.01) and pain-relief following the intervention (p=0.002) was significant for gender.
This study suggests that a high percentage of patients experienced acute postoperative pain despite routine nursing care, while evidence-based nursing practices could significantly alleviate pain.
PMCID: PMC5020264  PMID: 27630865
Evidence-based medicine; Surgery; Pain
2.  The Effect of Aloe Vera Solution on Chemotherapy-Induced Stomatitis in Clients with Lymphoma and Leukemia: A Randomized Controlled Clinical Trial 
Stomatitis is the most common complication of chemotherapy. This study aimed to assess the effect of aloe vera solution on stomatitis and its pain intensity in patients undergoing chemotherapeutic procedures.
In this randomized controlled clinical trial, 64 patients with Acute Myeloid Leukemia and Acute Lymphocytic Leukemia undergoing chemotherapy were randomly divided into a control and an intervention group. The intervention group patients were asked to wash their mouths with 5 ml of aloe vera solution for two minutes three times a day for 14 days. The control group patients, however, used only the ordinary mouthwashes recommended in hematologic centers. The patients’ mouths were examined by two assistants on days 1, 3, 5, 7, and 14. The intensity of stomatitis was recorded according to WHO stomatitis intensity checklists and pain was evaluated using Visual Analog Scale. The data were analyzed by SPSS statistical software, version 18.
The results showed that aloe vera solution mouthwash significantly reduced the intensity of stomatitis and its pain in the intervention group compared to the control group. On the first day, no significant difference was found between the two groups regarding the mean intensity of stomatitis (P=0.178) and pain (P=0.154). However, a significant difference was observed between the two groups in this regard on other days (days 3-14: P=0.001 for stomatitis intensity, P=0.001 for pain).
Aloe vera solution can improve the patients’ nutritional status, reduce stomatitis and its pain intensity, and increase the patients’ satisfaction.
Trial Registration Number IRCT2014092819318N1
PMCID: PMC4876780  PMID: 27218109
Aloe vera; Chemotherapy; Leukemia; Lymphoma; Stomatitis
3.  Self-Rated Attentiveness Interacts with Transcranial Direct Current Stimulation and Noise Stimulation in Reaction Time in a Go/No-Go Task 
Neural Plasticity  2016;2016:5302538.
Previous research has found that stimulating inattentive people with auditory white noise induces enhancement in cognitive performance. This enhancement is believed to occur due to a statistical phenomenon called stochastic resonance, where noise increases the probability of a signal passing the firing threshold in the neural cells. Here we investigate whether people with low attentiveness benefit to a larger extent than attentive people from stimulation by auditory white noise and transcranial direct current stimulation (tDCS). The results show, for both auditory noise and tDCS stimulation, that the changes in performance relative to nonstimulation correlate with the degree of attentiveness in a Go/No-Go task, but not in a N-back task. These results suggest that the benefit of tDCS may interact with inattentiveness.
PMCID: PMC4736978  PMID: 26881116
4.  An in vitro model for hepatocyte-like cell differentiation from Wharton’s jelly derived-mesenchymal stem cells by cell-base aggregates  
The present study investigated the differentiation potential of human Umbilical Cord Mesenchymal Stem Cells (UCMSCs) into hepatic lineage through embryonic body-like aggregate formation in the presence of IGF-1.
Cells derived from Wharton’s jelly have been reported to display a wide multilineage differentiation potential, showing some similarities to both embryonic (ESC) and mesenchymal stem cells (MSCs).
Patients and methods:
Human MSCs isolated from the umbilical cord were plated in 20 μL micro drops. A two-step differentiation protocol was used and the cell aggregates were exposed to the media supplemented with IGF, HGF, oncostatin M, and dexamethasone for 21 days. Immunoperoxidase and immuno-fluorescence were performed for cyrokeratins 18, 19 and albumin. Functional assays were done by periodic acid Schiff (PAS) and indocyanine green.
The expression of cytokeratin 19 was shown to be higher in the cells derived from 3D spheroids compared to those cultured in conventional protocol. They showed a polygonal shape after being exposed to hepatogenic media. Immunostaining demonstrated the expression of cytokeratin-18, 19 and albumin by the differentiated cells. Besides, PAS staining revealed glycogen storage in differentiated cells. Also, a greater number of large size differentiated cells were found at the periphery of the expanded cell aggregates.
We established a protocol for UCMSC differentiation into hepatocytes and these cells were morphologically and functionally similar to hepatocytes. Thus, hepatocyte differentiation may be facilitated by the UCMSCs aggregate formation before administration of the differentiation protocols.
PMCID: PMC4553159  PMID: 26328041
Cell aggregate; Liver; Mesenchymal stem cells; Umbilical cord
5.  Investigation of FOXP3 genetic variations at positions -2383 C/T and IVS9+459 T/C in southern Iranian patients with lung carcinoma 
FOXP3 gene is an X-linked gene that encodes FOXP3 protein, an essential transcription factor in CD4+CD25+FOXP3+ regulatory T (Treg) cells. We aimed, in the present study, to investigate the association of two FOXP3 polymorphisms, -2383 C/T (rs3761549) and IVS9+459 T/C (rs2280883), with lung cancer.
Materials and Methods:
In a case-control study we analyzed genotypes and alleles frequencies at -2383 C/T and IVS9+459 T/C positions in 156 patients with lung cancer and 156 age and sex matched healthy controls in Southern Iranian population, using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methods. The data were verified by direct automated DNA sequencing.
The frequency of -2383 T allele was significantly higher in the patients than in the control group (11.8% versus 5.9%, P-value=0.04, OR=2.13, 95%CI=1.04-4.54). T allele frequency at IVS9+459 T/C position was higher, compared to the controls, in the patients who presented the disease over 55 years old (69.9% versus 59.1%, P-value=0.04, OR=1.61, 95%CI=1.01-2.55) and also in SCLC patients (77.8% versus 59.1%, P-value=0.03, OR=2.42, 95%CI=1.05-5.59). No significant differences were found in the genotypes and haplotypes distributions between the cases and controls. A high degree of linkage disequilibrium was observed between two polymorphisms.
As the first study dealing with -2383 C/T and IVS9+459 T/C in lung cancer, our data conclusively suggest the association of -2383 T allele with susceptibility to lung cancer in Iranian population. The association of IVS9+459 T allele with susceptibility to lung cancer in old patients suggests the age-dependent effects of FOXP3 gene on cancer occurrence.
PMCID: PMC4475654  PMID: 26124932
FOXP3 gene; Gene polymorphism; Lung cancer; PCR-RFLP
6.  Wharton’s Jelly-derived Mesenchymal Stem Cells can Differentiate into Hepatocyte-like Cells by HepG2 Cell Line Extract 
Wharton’s jelly is an unlimited source of stem cells that can be used in cell therapy and tissue engineering without any ethical concern. It has been revealed the cell-free extract could be effective to induce cell differentiation. The objective of this study was to induce Wharton’s jelly-derived mesenchymal stem cells (MSCs) into hepatocyte-like cells by premeabilization of the cells in the presence of HepG2 cell line extract.
MSCs were isolated from the umbilical cord, CD marker profile and their differentiation potential into adipogenic and osteogenic lineages were determined. The cells were then, permeabilized by streptolysin O in the presence of HepG cell extract. The treated cells were cultured for 17 days. The cell phenotype was evaluated and the hepatocyte specific markers were detected by immunofluorescence and immunocytochemistry. The Periodic Acid Schiff (PAS) reaction and the cellular uptake of indocyanine green were performed to evaluate the functional behavior of the differentiated cells.
The phenotype of extract-treated MSCs changed into a round or polygonal cells with few short processes and they could express high level of albumin, cytokeratin 18 and 19. The MSCs also could store glycogen and uptake and release indocyanine green.
We demonstrated for the first time that Wharton’s jelly-derived MSCs could differentiate into hepatocyte-like cells by premeabilization of them in the presence of HepG2 cell extract. This study suggests a feasible method to differentiate MSCs into functional hepatocyte-like cells.
PMCID: PMC4359934  PMID: 25821294
Wharton’s jelly; Mesenchymal stem cells; Cell differentiation; Cell-free system
7.  A model for prediction of cisplatin induced nephrotoxicity by kidney weight in experimental rats 
Cisplatin (cis-diamminedichloroplatinum II; CP) is used widely as an antitumor drug in clinics, but is accompanied with renal toxicity. Cisplatin induced nephrotoxicity consists of change in kidney weight, histological changes in kidney and increase in serum creatinine (Cr) and blood urea nitrogen (BUN). This study was designed to find out a model for prediction of cisplatin induced nephrotoxicity.
Materials and Methods:
Pathological damage score, kidney weight, BUN, and Cr of 227 rats that were involved in different projects were determined. A total of 187 rats were treated with 7 mg/kg cisplatin and sacrificed 1 week later.
There was a good significant correlation between normalized kidney weight and logarithmic scale of BUN and Cr. Relationship between BUN, Cr or normalized kidney weight and pathology damage score was significant.
Normalized kidney weight and pathology damage score is a good predictor of renal function in cisplatin induced nephrotoxicity in experimental rats.
PMCID: PMC3810567  PMID: 24174938
Cisplatin; kidney weight; nephrotoxicity; pathology; rat
8.  Protective Role of Silymarin and Deferoxamine Against Iron Dextran-induced Renal Iron Deposition in Male Rats 
Kidney iron deposition (KID) is caused by iron overload that is observed in kidney diseases and anemia. The protective effects of deferoxamine (DF) and silymarin (SM) were studied against iron overload-induced KID in rat model.
Rats received iron dextran (200 mg/kg) for a period of 4 weeks every other day, but at the beginning of week 3, they also were subjected to a 2-week (every other day) treatment with vehicle (group 2, positive control), SM (200 mg/kg; group 3), DF (50 mg/kg; group 4), SM (400 mg/kg; group 5), and combination of SM and DF (200 and 50 mg/kg, respectively; group 6). Group 1, as the negative control, received saline alone during the study. The levels of serum creatinine (Cr), blood urea nitrogen (BUN), iron, ferritin, and nitrite were determined, and the kidney was removed for histopathological investigations.
Before treatment, the serum levels of iron and ferritin in all iron dextran receiver groups were significantly higher than those of the negative control group (P < 0.05). However, the serum levels of BUN, Cr, and nitrite were not different between the groups. No statistical differences were detected in kidney weight and the serum levels of BUN, Cr, iron, ferritin, and nitrite after 2 weeks of treatment with SM, DF, or combination of both. The SM and DF treatments reduced the intensity of the KID, but only in the SM (200 mg/kg) group, a significant reduction in KID was observed (P < 0.05).
It seems that SM is a nephroprotectant agent against KID in acute iron overload animal models.
PMCID: PMC3634167  PMID: 23626885
Deferoxamine; iron overload; kidney iron deposition; silymarin
9.  Evidence Against Protective Role of Sex Hormone Estrogen in Cisplatin-Induced Nephrotoxicity in Ovarectomized Rat Model 
Toxicology International  2013;20(1):43-47.
Cisplatin (CP) is an effective drug in cancer therapy to treat the solid tumors, but it is accompanied with nephrotoxicity. The protective effect of estrogen in cardiovascular diseases is well-documented; but its nephron-protective effect against CP-induced nephrotoxicity is not completely understood.
Materials and Methods:
Thirty ovarectomized Wistar rats were divided in to five groups. Groups 1-3 received different doses of estradiol valerate (0.5, 2.5 and 10 mg/kg/week) in sesame oil for 4 weeks, and at the end of week 3, a single dose of CP (7 mg/kg, intraperitoneal [IP]) was administrated. Group 4 (positive control) received the same regimen as group 1-3 without estradiol without vehicle. The negative control group (Group 5) received sesame oil during the study. The animals were sacrificed 1 week after CP injection for histopathological studies.
The serum level of blood urea nitrogen and creatinine, kidney tissue damage score (KTDS), kidney weight and percentage of body weight change in CP-treated groups significantly increased (P < 0.05), however, there were no significant differences detected between the estrogen-treated groups (Groups 1-3) and the positive control group (Group 4). Although, estradiol administration enhanced the serum level of nitrite, it was not affected by CP. Finally, significant correlation between KTDS and kidney weight was detected (r2 = 0.63, P < 0.01).
Estrogen is not nephron-protective against CP-induced nephrotoxicity. Moreover, it seems that the mechanism may be related to estrogen-induced oxidative stress in the kidney, which may promote the nephrotoxicity.
PMCID: PMC3702126  PMID: 23833437
Cisplatin; estrogen; nephrotoxicity; ovarectomized rat
10.  Medians seek the corners, and other conjectures 
BMC Bioinformatics  2012;13(Suppl 19):S5.
Median construction is at the heart of several approaches to gene-order phylogeny. It has been observed that the solution to a median problem is generally not unique, and that alternate solutions may be quite different. Another concern has to do with a tendency for medians to fall on or near one of the three input orders, and hence to contain no information about the other two.
We conjecture that as gene orders become more random with respect to each other, and as the number of genes increases, the breakpoint median for circular unichromosomal genomes, in both the unsigned and signed cases, tends to approach one of the input genomes, the "corners" in terms of the distance normalized by the number of genes. Moreover, there are alternate solutions that approach each of the other inputs, so that the average distance between solutions is very large. We confirm these claims through simulations, and extend the results to medians of more than three genomes.
This effect also introduces serious biases into the medians of less scrambled genomes. It prompts a reconsideration of the role of the median in gene order phylogeny. Fortunately, for triples of finite length genomes, a small proportion of the median solutions escape the tendency towards the corners, and these are relatively close to each other. This suggests that a focused search for these solutions, though they represent a decreasing minority as genome length increases, is a way out of the pathological tendency we have described.
PMCID: PMC3526443  PMID: 23281922
11.  Vitamin E, Vitamin C, or Losartan Is Not Nephroprotectant against Cisplatin-Induced Nephrotoxicity in Presence of Estrogen in Ovariectomized Rat Model 
Background. The nephroprotective effect of vitamins E and C or losartan against cisplatin (CP)- induced nephrotoxicity when they are accompanied by estrogen was investigated. Methods. The ovariectomized rats received estradiol valerate for two weeks. At the end of the first week, a single dose of CP (7 mg/kg, IP) was also administered, and they received placebo (group 1), vitamin E (group 2), vitamin C (group 3), or losartan (group 4) every day during the second week, and they were compared with another three control groups. Results. CP alone increased the serum levels of blood urea nitrogen (BUN), creatinine (Cr), and kidney tissue damage score (KTDS), significantly (P < 0.05), however at the presence of estradiol and CP, vitamin C, vitamin E, or losartan not only did not decrease these parameters, but also increased them significantly (P < 0.05). The serum level of superoxidase dismutase (SOD) was reduced by CP (P < 0.05), but it was increased when estradiol or estradiol plus vitamin C or losartan were added (P < 0.05). Conclusion. The particular pharmacological dose of estrogen used in this study abolish the nephroprotective effects vitamins C and E or losartan against CP-induced nephrotoxicity.
PMCID: PMC3463913  PMID: 23056943
12.  General Analytical Schemes for the Characterization of Pectin-Based Edible Gelled Systems 
The Scientific World Journal  2012;2012:967407.
Pectin-based gelled systems have gained increasing attention for the design of newly developed food products. For this reason, the characterization of such formulas is a necessity in order to present scientific data and to introduce an appropriate finished product to the industry. Various analytical techniques are available for the evaluation of the systems formulated on the basis of pectin and the designed gel. In this paper, general analytical approaches for the characterization of pectin-based gelled systems were categorized into several subsections including physicochemical analysis, visual observation, textural/rheological measurement, microstructural image characterization, and psychorheological evaluation. Three-dimensional trials to assess correlations among microstructure, texture, and taste were also discussed. Practical examples of advanced objective techniques including experimental setups for small and large deformation rheological measurements and microstructural image analysis were presented in more details.
PMCID: PMC3354751  PMID: 22645484
13.  The protective role of endogenous nitric oxide donor (L-arginine) in cisplatin-induced nephrotoxicity: Gender related differences in rat model 
Cisplatin (CP) as a potential drug for solid tumors produces nephrotoxicity and disturbs endothelial function. CP induced nephrotoxicity may be gender related. Nitric oxide plays a pivotal role in endothelial function and L-arginine as endogenous NO donor promotes endothelial function. The role of L-arginine in CP induced nephrotoxicity model and its gender related was investigated in this study.
Thirty three Wistar rats were randomly assigned to four groups. The groups 1 (male, n = 6) and 2 (female, n = 11) received a single dose of L-arginine (300 mg/kg, ip), and the day after, they received a single dose of CP (7 mg/kg). The group 3 (male, n = 9) and 4 (female, n = 7) were assigned to the same regimen except for saline instead of L-arginine. All animals were sacrificed one week after CP administration. The levels of blood urea nitrogen (BUN), creatinine and nitrite were measured. The kidneys were also removed for pathological investigations.
Five animals died. All CP treated animals lost weight. The normalized weigh loss was significantly different between male and female in CP+L-arginine treated animals (p < 0.05). BUN and creatinine were increased significantly in male treated with CP and in female treated with CP+L-arginine (p < 0.05). L-arginine reduced BUN in male (not in female) when compared with control groups (p < 0.05). The level of nitrite was increased significantly in L-arginine treated animals. Kidney tissue damage score and normalized kidney weight were greater in females treated with CP+ L-arginine than female received CP alone (p < 0.05).
L-arginine may protect against CP induced nephrotoxicity in male, but it promotes the induced damage in female. The exact mechanism need to be defined.
PMCID: PMC3430054  PMID: 22973338
Gender; L-arginine; Cisplatin; Nephrotoxicity; Rat

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