ABSTRACT Objectives: To assess serum anti-Müllerian hormone (AMH) levels as an ovarian reserve marker in adolescent girls with autoimmune thyroiditis (AIT) and explore the relationship of this marker with autoimmunity and thyroid function biomarkers. Subjects and methods: This study included 96 adolescent girls with newly diagnosed AIT and 96 healthy, age- and sex-matched controls. All participants were evaluated with detailed history taking and physical examination, thyroid ultrasound, and measurement of levels of thyroid-stimulating hormone (TSH), free thyroxin (FT4), free triiodothyronine (FT3), antithyroid peroxidase antibodies (TPOAb), antithyroglobulin antibody (TGAb), estradiol, total testosterone, and anti-Müllerian hormone (AMH) levels. The LH/FSH ratio was also calculated. Among 96 patients evaluated, 78 were overtly hypothyroid and 18 were euthyroid. AMH levels were significantly lower in participants with overt hypothyroidism and euthyroidism compared with controls. Results: Serum levels of AMH correlated negatively with age, body mass index (BMI) standard deviation score (SDS), and TPOAb, TGAb, and TSH levels but positively with FT4 levels. In multivariate analysis, AMH levels correlated significantly with age (odds ratio [OR] = 1.65, 95% confidence interval [CI] 1.18-2.32, p = 0.05), BMI SDS (OR = 2.3, 95% CI, 2.23-3.50, p = 0.01), TSH (OR = 2.43, 95% CI 1.5-2.8, p = 0.01), and TPOAb (OR = 4.1, 95% CI 3.26-8.75, p = 0.001). Conclusions: Ovarian reserve of adolescent girls with AIT, as measured by serum AMH levels, is affected by thyroid autoimmunity and hypothyroidism, indicating a possible need for ovarian reserve monitoring in these patients.

Abstract Seismic tomography has been extensively used in geophysics for different purposes, including geological mapping, characterisation of inner earth structure and prospecting for oil and gas. In geophysics, seismic or electromagnetic waves are commonly used to provide tomographic information. In the geotechnical area, seismic tomography is emerging as a promising technique that can be used to determine the spatial variability of shear wave velocities and hence the small strain stiffness of geomaterials, especially when used in the centrifuge where in-situ stress conditions can be mimicked closely. This paper describes the development of a seismic tomography technique in the centrifuge. This technology can be used to image variations of soil stiffness under various mechanical, chemical and physical conditions. The paper describes the various components of the system, which includes arrays of small-size bender elements, hardware and software used to transmit, receive and acquire the shear wave signals during a centrifuge test. The paper illustrates the performance of the system at both 1g and in the centrifuge. Results of tomographic inversion performed on travel-time data obtained from these tests are discussed.

ABSTRACT Objective: The aim of this study was to determine the determinants of socio-economic inequality in the prevalence of short stature and underweight in Iranian children and adolescents. Subjects and methods: This cross-sectional nationwide study was conducted on 36,486 participants, aged 6-18 years. This school-based surveillance (CASPIAN- IV) program and its complementary part on weight disorders evaluation was conducted in urban and rural areas of 30 provinces in Iran. In addition to physical examination, a validated questionnaire was completed from students and their parents. Socio-economic status (SES) was determined using principal component analysis, and was classified in quintile scale. Inequality in the prevalence of underweight and short stature was assessed using concentration (C) index and slop index of inequality (SII) by the Oaxaca-Blinder decomposition method. Results: The prevalence (95% CI) of underweight and short stature at national level was 10.89 (10.55, 11.23) and 4.15 (3.94, 4.38), respectively; it had a downtrend from the lowest to highest SES quintile. Furthermore, the value of C for underweight and short stature was negative, i.e. inequality was in favor of high SES groups. Moreover, the prevalence gap of underweight and short stature in the first and fifth quintiles of SES was 6.58% and 5.80%, respectively. The highest proportion of this gap was explained by living area. In the multiple logistic model, odds of underweight and short stature were significantly lower in individuals with higher SES. Compared to boys, odds of underweight were decreased in girls, whereas odds of short stature were increased in them. Odds of underweight and short stature were increased in participants from rural areas than in urban areas. With increasing age, the odds of underweight and short stature decreased significantly. Conclusions: The results of this study showed that inequality in the prevalence of short stature and underweight was in favor of high SES groups. Moreover, living area was one of the most important determinants that explained this inequality. Therefore, this issue needs to be considered in health promotion policies.

A sensitive, accurate electrochemical sensor based on reduced graphene oxide modified carbon paste electrode (RGO/CPE) was developed to measure curcumin levels in human blood serum. The as-prepared electrode (RGO/CPE) was verified to outperform bare carbon paste electrode (CPE), with increased oxidation and reduction peaks at +0.505 V and +0.408 V, respectively. Curcumin measurement was performed using cyclic voltammetry (CV) and differential pulse voltammetry (DPV) techniques. RGO/CPE showed a desirable linear response towards curcumin, within the concentration range of 10-6000 µM; the detection limit (S/N = 3) was 3.183 µM. Moreover, electrochemical impedance spectroscopy (EIS) and field emission scanning electron microscope (FESEM) were applied to gain further insight into the electrochemical behavior of the proposed electrode. The results revealed that the usage of RGO caused increased sensitivity of the sensor response to curcumin; therefore, RGO/CPE can be considered a promising electrochemical sensor for curcumin determination in human blood serum.

ABSTRACT Introduction: Hepatitis B virus (HBV) is responsible for one of the most common human viral infections. An estimated 257 million people are living with chronic HBV infection worldwide, and mortality has reached 900,000 deaths in recent years. In 2001, the World Health Organization reported a prevalence of chronic hepatitis B infection in Iran between 2-7%. Objective: To assess the effect of the national HBV mass vaccination program after 25 years. Methods: A retrospective cohort study was conducted in vaccinated and unvaccinated people according to the year of birth. Blood samples were obtained from each enrolled person and data about demographic variables, and medical and vaccination history were collected using a standardized questionnaire. Persons were considered uninfected if they were negative for both HBsAg and anti-HBc. Also, Vaccine effectiveness was measured by calculating the risk of disease among vaccinated and unvaccinated persons and defining the percentage risk reduction of infection in the vaccinated group. Results: A total of 2720 persons were interviewed. The rate of HBV breakthrough infection among the vaccinated group was significantly lower than in unvaccinated group. One hundred ninety-four cases with positive HBV markers of infection were identified. The risk ratio of HBV infection was 0.71, 95% CI: 0.54-0.94 (vaccinated/unvaccinated). The estimated vaccination effectiveness against Hepatitis B infection was 29% (95% CI: 6%-46%). Conclusions: Iran has successfully combined hepatitis B vaccination into regular immunization programs. The WHO goal of reducing HBsAg prevalence to an equivalent of 1% by 2020 has been reached. With respect to vaccination effectiveness and low prevalence of the disease in the country, catch-up hepatitis B vaccination programs for adolescents can guarantee the immunity of the population.

Abstract Quality of life drastically diminished after radiotherapy due to radiation induced oral complications. Fluoride was found to be helpful in decreasing the incidence of radiation caries; however it has not led to elimination of dental caries. Thus, new techniques containing low fluoride concentration or not containing fluoride at all, as laser irradiation, have been studied to prevent the beginning or progression of caries. So the purpose of this study is to investigate the effect of laser surface treatment with or without fluoride on microhardness and ultrastructure of demineralized gamma irradiated enamel; Thirty enamel slabs were allocated into three groups (n=10): G slabs were subjected to gamma irradiation only; GL slabs were subjected to gamma irradiation followed by diode laser and GFL slabs were subjected to gamma irradiation followed by fluoride then diode laser. Slabs were then exposed to demineralizing solution for 72 hours. Examination of slabs was performed using vickers microhardness test and scanning electron microscope; The lowest microhardness was recorded in group G, while inGL and GFL groups it significantly increased. Scanning electron microscope revealed a pronounced loss of central prism core and retention of prism peripheries in group G. Confluence of prismatic and interprismatic structures in GL slabs and irregular rough surface with prismatic boundaries conservation in GFL slabs were detected. Applying laser improved the microhardness and counteracted the adverse effect of gamma radiation. Adding fluoride before laser irradiation had a marked effect on microhardness..

Abstract Introduction Different types of autologous graft materials are used for myringoplasty, with the temporalis fascia and cartilage being the most frequently used tissues. Periosteal tissue has been used for a long time in our department, and many advantages support its use in myringoplasty. To the best of our knowledge, this issue is scarcely discussed in the previously published literature. Objective To present our experience with periosteal graft myringoplasty, describing the technique and the anatomical and functional outcomes. Methods A prospective clinical study involving 88 patients (72 females and 16 males) with a mean age 26.9 years. The patients underwent myringoplasty using the mastoid cortex periosteum; they were all operated using the postauricular approach, and the graft was applied using the underlay technique. The patients performed pre- and postoperative pure tone audiometry for tested frequencies (0.5 kHz, 1 kHz, 2 kHz, and 4 kHz). All patients were followed-up for at least 12 months after the operation. Results The anatomical success rate among all patients was of 93%, which is comparable to the rate of success in procedures using other usual grafting materials. In addition, there was a highly significant postoperative improvement in pure tone audiometry results as compared with the preoperative ones (the main hearing gain was of ∼ 11 dB; p< 0.001). Conclusion The periosteal graft is easily harvested, easy to apply, with excellent anatomical and functional success.

Resumo Objetivo A obesidade infantil se tornou uma preocupação de saúde prioritária em todo o mundo. A situação socioeconômica (SSE) é um de seus principais determinantes. Este estudo tem como objetivo avaliar a desigualdade socioeconômica com relação à obesidade entre crianças e adolescentes em nível nacional e subnacional no Irã. Métodos Este estudo transversal multicêntrico foi conduzido em 2011-2012 como parte de um programa nacional de vigilância escolar realizado com 40000 alunos, com idade entre 6-18 anos, de áreas urbanas e rurais de 30 províncias do Irã. Utilizando a análise de componentes principais, a SSE dos participantes foi categorizada em quintis. A desigualdade da SSE no excesso de peso foi estimada pelo cálculo da prevalência de excesso de peso (ou seja, sobrepeso, obesidade geral e obesidade abdominal) em todos os quintis da SSE, o índice de concentração (C) e o slope index of inequality (SII). Os determinantes dessa desigualdade foram determinados pela decomposição de Oaxaca-Blinder. Resultados No total, 36529 alunos completaram o estudo (taxa de resposta: 91,32%), dos quais 50,79% eram meninos e 74,23%, habitantes urbanos. A idade média (DP) foi 12,14 (3,36) anos. A prevalência de sobrepeso, obesidade geral e obesidade abdominal foi 11,51%, 8,35% e 17,87%, respectivamente. A SSE com relação a sobrepeso, obesidade e obesidade abdominal foi -0,1, -0,1 e -0,15, respectivamente. O índice C com relação a sobrepeso, obesidade geral e obesidade abdominal foi positivo, o que indica que a desigualdade estava em favor de grupos de baixa SSE. A área de residência, o histórico familiar de obesidade e a idade foram os fatores que mais contribuíram para a desigualdade da prevalência de obesidade observados entre os grupos em SSE mais alta e mais baixa. Conclusão Este estudo fornece informações consideráveis sobre a alta prevalência de excesso de peso em famílias em SSE mais alta em nível nacional e subnacional. Esses achados podem ser usados para comparações internacionais e políticas de saúde, melhorar a programação ao considerar as diferenças em nível subnacional.

Abstract Objective Childhood obesity has become a priority health concern worldwide. Socioeconomic status is one of its main determinants. This study aimed to assess the socioeconomic inequality of obesity in children and adolescents at national and provincial levels in Iran. Methods This multicenter cross-sectional study was conducted in 2011-2012, as part of a national school-based surveillance program performed in 40,000 students, aged 6-18-years, from urban and rural areas of 30 provinces of Iran. Using principle component analysis, the socioeconomic status of participants was categorized to quintiles. Socioeconomic status inequality in excess weight was estimated by calculating the prevalence of excess weight (i.e., overweight, generalized obesity, and abdominal obesity) across the socioeconomic status quintiles, the concentration index, and slope index of inequality. The determinants of this inequality were determined by the Oaxaca Blinder decomposition. Results Overall, 36,529 students completed the study (response rate: 91.32%); 50.79% of whom were boys and 74.23% were urban inhabitants. The mean (standard deviation) age was 12.14 (3.36) years. The prevalence of overweight, generalized obesity, and abdominal obesity was 11.51%, 8.35%, and 17.87%, respectively. The SII for overweight, obesity and abdominal obesity was -0.1, -0.1 and -0.15, respectively. Concentration index for overweight, generalized obesity, and abdominal obesity was positive, which indicate inequality in favor of low socioeconomic status groups. Area of residence, family history of obesity, and age were the most contributing factors to the inequality of obesity prevalence observed between the highest and lowest socioeconomic status groups. Conclusion This study provides considerable information on the high prevalence of excess weight in families with higher socioeconomic status at national and provincial levels. These findings can be used for international comparisons and for healthcare policies, improving their programming by considering differences at provincial levels.

We report on the synthesis of dopamine loaded magnetic nanoparticles (MNPs) for new, simple, fast and repeatable extraction of ochratoxin A from different solvents and milk without utilizing immunoaffinity columns and even high-tech devices. To this end, Fe3O4 nanoparticles (NPs) were synthesized using thermal decomposition reaction and dopamine (DPA) was then conjugated with Fe3O4 nanoparticles (NPs) to form Fe3O4-DPA NPs. Dynamic light scattering, field emission scanning electron microscopy and transmission electron microscopy revealed an average size of about 15 nm for Fe3O4-DPA NPs. Moreover, zeta potential measurement and vibrating sample magnetometer confirmed positively charged (16.8 mV) and superparamagnetic behavior of MNPs, which are effective factors for a good adsorbent in the extraction. Various solvents and different effective parameters were measured until acetonitrile:methanol was selected as the best extraction solvent. In addition, based on the pH-partition theory, with changes in pH, we were able to increase and enhance the extraction rate to 94%. Moreover, the ability of Fe3O4-DPA NPs in solid phase extraction of ochratoxin A from spiked milk was evaluated. The recovery rate for extraction of OTA from milk was 68%.

Novel silver-doped nickel titanate nanoparticles (Ag-NiTiO3) were successfully prepared via a sol-gel method in the presence of stearyl alcohol as the capping agent and solvent. The formation of pure crystallized nickel titanate and silver-doped nickel titanate was occurred when the precursor was heat-treated at 700 °C in air for 150 and 60 min, respectively. The structural, morphological, and optical properties of obtained products were characterized by techniques such as X-ray diffraction (XRD), Fourier transform infrared (FT-IR) spectroscopy, Energy dispersive X-ray microanalysis (EDX), ultraviolet-visible (UV-vis), and scanning electron microscopy (SEM). The magnetic property of the prepared Ag-NiTiO3 nanoparticles was also investigated with vibrating sample magnetometer (VSM). To fabricate a FTO/TiO2/Ag-NiTiO3/Pt-FTO solar cell, Ag-NiTiO3 film was directly deposited on top of the TiO2 prepared by electrophoresis deposition method. Furthermore, solar cell result indicates that an inexpensive solar cell could be developed by the synthesized Ag-NiTiO3 nanoparticles.

RESUMO O efeito de proteína bruta (PB), amino ácido (AA) e balanço alimentar eletrolítico (DAE) foi avaliado por parâmetros sanguíneos, características da carcaça e desempenho de aves de corte sob estresse calórico (29-34°C). Quinhentos e quarenta machos (Ross 308) foram alocados em 12 regimes alimentares num arranjo fatorial 2 × 2 × 3 totalmente aleatório com 3 repetições de 15 aves em períodos de crescimento (13 a 26 dias) e terminação (27 a 42 dias) e 120, 220 e 320 mEq kg-1 DAE. Além disso, 21% de PB aumentou o ganho de peso corporal (GPC) e diminuiu a conversão alimentar (CAR) no período de crescimento (p < 0.05). Por outro lado, 20% de PB diminuiu GPC e aumentou CAR no período terminal (p < 0.05). O nível de 20% PB reduziu o sódio sanguíneo e o balanço eletrolítico sanguíneo (p < 0.05). O maior balanço eletrolítico sanguíneo ocorreu com DAE 320 mEq kg-1 dieta (p < 0.05). A resposta das aves de corte a DAE no estresse calórico dependia da idade da ave, à exposição a altas temperaturas e ao nível de PB na dieta. Sob estresse calórico (29-34°C), 21% PB no período de crescimento e 17% de PB no período de terminação melhoraram o GPC e CAR das aves de corte.

ABSTRACT The effect of crude protein (CP), amino acid (AA), and dietary electrolyte balance (DEB) were evaluated on blood parameters, carcass traits, and broiler performance under heat stress (29-34°C). A total of 540 male chickens (Ross 308) were allocated to 12 diets with factorial arrangement 2 × 2 × 3, using a completely randomized design with three replicates of 15 chickens in grower (13 to 26 days) and finisher (27 to 42 days) periods. and 120, 220, and 320 mEq kg-1 DEB. The level of 21% CP increased body weight gain (BWG) and decreased feed conversion ratio (FCR) at grower period (p < 0.05). In contrast, 20% CP level decreased BWG and increased FCR at finisher period (p < 0.05). Further, 20% CP level reduced blood sodium and blood electrolyte balance (p < 0.05). The highest blood electrolyte balance was achieved by DEB 320 mEq kg-1 diet (p < 0.05). Broiler response to DEB in heat stress depended on the age of bird, length of exposure to high temperature and CP level of the diet. Under heat stress (29-34°C), the 21% CP level at grower period and 17% CP level at finisher period improved broiler BWG and FCR.

Resumo Objetivo: Avaliar o efeito da adição de sufentanil à bupivacaína hiperbárica na duração do bloqueio sensorial da raquianestesia em usuários crônicos de opioides em comparação com não adictos. Métodos: Foram distribuídos em quatro grupos 60 pacientes agendados para cirurgia ortopédica sob raquianestesia: Grupo 1 (sem história de uso de ópio, recebeu bupivacaína hiperbárica intratecal juntamente com 1 mL de solução salina como placebo); Grupo 2 (sem história de uso de ópio, recebeu bupivacaína intratecal juntamente com 1 mL de sufentanil [5 µg]); Grupo 3 (com história de uso de ópio, recebeu bupivacaína intratecal juntamente com 1 mL de solução salina como placebo) e Grupo 4 (com história de uso de ópio, recebeu bupivacaína intratecal juntamente com 1 mL de sufentanil [5 µg]). O tempo de início e a duração dos bloqueios sensitivo e motor foram registrados. Resultados: A duração do bloqueio sensorial no Grupo 3 foi de 120 ± 23,1 min, um tempo significativamente menor do que nos outros grupos (G1 = 148 ± 28,7, G2 = 144 ± 26,4, G4 = 139 ± 24,7, p = 0,007). A duração do bloqueio motor no Grupo 3 foi de 145 ± 30,0 min, um tempo significativamente menor do que nos outros grupos (G1 = 164 ± 36.0, G2 = 174 ± 26.8, G4 = 174 ± 24,9; p = 0,03). Conclusões: A adição de 5 µg de sufentanil intratecal à bupivacaína hiperbárica em usuários crônicos de opioides aumenta a duração dos bloqueios sensorial e motor de forma equivalente ao bloqueio avaliado em não adictos.

Abstract Objective: The primary outcome of this study was to evaluate the effect of adding sufentanil to hyperbaric bupivacaine on duration of sensory blockade of spinal anesthesia in chronic opioid users in comparison with non-addicts. Methods: Sixty patients scheduled for orthopedic surgery under spinal anesthesia were allocated into four groups: group 1 (no history of opium use who received intrathecal hyperbaric bupivacaine along with 1 mL saline as placebo); group 2 (no history of opium use who received intrathecal bupivacaine along with 1 mL sufentanil [5 µg]); group 3 (positive history of opium use who received intrathecal bupivacaine along with 1 mL saline as placebo) and group 4 (positive history of opium use who received intrathecal bupivacaine along with 1 mL sufentanil [5 µg]). The onset time and duration of sensory and motor blockade were measured. Results: The duration of sensory blockade in group 3 was 120 ± 23.1 min which was significantly less than other groups (G1 = 148 ± 28.7, G2 = 144 ± 26.4, G4 = 139 ± 24.7, p = 0.007). The duration of motor blockade in group 3 was 145 ± 30.0 min which was significantly less than other groups (G1 = 164 ± 36.0, G2 = 174 ± 26.8, G4 = 174 ± 24.9, p = 0.03). Conclusions: Addition of 5 µg intrathecal sufentanil to hyperbaric bupivacaine in chronic opioid users lengthened the sensory and motor duration of blockade to be equivalent to blockade measured in non-addicts.

Abstract Aim The aim of this study was to compare both the efficacy and safety profile of the WHO-recommended, dual therapy (doxycycline–rifampin) to a quinolone-based, triple therapy (doxycycline–rifampin–levofloxacin) for treating acute/subacute brucellosis. Patients and methods We studied 107 consecutive, naïve patients with acute/subacute brucellosis admitted to Assiut University Hospital. Patients were randomly allocated to receive the dual therapy of doxycycline–rifampin (group-A) or to receive the triple therapy of doxycycline–rifampin–levofloxacin (group-B). Acute/subacute brucellosis was diagnosed based on the presence of: (1) contact with animals or fresh animal products, (2) suggestive clinical manifestations of less than one-year duration, and (3) positive antibody titer (1:160) by standard tube agglutination test. Results There was no significant difference between the two groups regarding their demographic data. Fever was the most frequent manifestation (96.3%). Epigastric pain was the most frequent adverse effect of treatment (12.1%). Group-A patients had a significantly higher relapse rate compared to group-B patients (22.6% versus 9.3%, p-value = 0.01). The rate of treatment adverse effects was higher among group-B patients, although not reaching statistical significance (20.4% versus 11.3%, p-value = 0.059). Conclusions Adding levofloxacin to the dual therapy for acute/subacute brucellosis (doxycycline–rifampin) may increase its efficacy in terms of lowering the relapse rate of the disease. Further, larger scale studies are needed before considering modifying the standard, dual therapy for brucellosis.

The early Miocene Qom Formation is exposed in the Bagh section, northeast Isfahan, Central Iran, where it unconformably overlies Oligocene deposits and is unconformably overlain by the Upper Red Formation. The formation is mainly represented by carbonate deposits (marl, marly limestone facies) and subordinate siliciclastic facies. The planktonic foraminiferal biostratigraphical analysis led to recognition of two main planktonic foraminiferal zones: 1. the Globigerinoides primordius Zone in the lowermost part of the section indicating early Miocene (Aquitanian) and 2. the Globigerinoides trilobus Zone in the upper most part of the Qom Formation of Burdigalian age (early Miocene). Composition and abundance of benthic and planktonic foraminifers were examined for paleoenvironment reconstruction and paleoecology. The Q-mode cluster analysis performed on the benthic foraminifers led us subdivide the section into three distinct benthic foraminiferal clusters: I. the Cibicidoides ungerianus cluster in the lower part of succession, indicating predominantly inner neritic environments; II. the Lenticulina orbicularis cluster in the middle part of section, indicative of middle-outer neritic environments, and III. the Elphidium-Amphistegina cluster recorded in the upper part of the formation and characterizing a typical outer neritic environment. The planktonic foraminifers are interspersed in the upper part of the section with relatively low diversity, indicating open marine shelf segments, whereas the lower part of the section is characterized by an abundance of benthic foraminifers. As a point to consider for paleoecology and paleoenvironment, abundant although with low diversity benthic foraminifera with small tests, and calculated data based on these clusters are indicative of high nutrient and high oxygen environment with normal marine salinity during the early Miocene at the Bagh section.

La Formación Qom del Mioceno temprano está expuesta en la sección Bagh, al noreste de Isfahan, Irán Central, en donde sobreyace discordantemente a los depósitos del Oligoceno, y a su vez, está cubierta discordantemente por la Formación Upper Red. La formación está compuesta principalmente por depósitos de carbonatos (margas, facies de calizas margosas) y facies subordinadas de siliciclásticos. Los análisis bioestratigráficos de foraminíferos planctónicos permitieron reconocer dos zonas principales: 1. Zona de Globigerinoides primordiusen en la parte inferior de la sección, indicando una edad del Aquitaniano (Mioceno temprano) y 2. Zona de Globigerinoides trilobus en la parte superior de la Formación Qom, representando una edad del Burdigaliano (Mioceno temprano). La composición y abundancia de foraminíferos bentónicos y planctónicos fue examinada para la reconstrucción del paleoambiente y paleoecología. Los análisis de grupo (cluster) en modo Q, realizados para los foraminíferos bentónicos, permitieron subdividir la sección en tres grupos distintos de foraminíferos bentónicos: I. Cibicidoides ungerianus, en la parte inferior de la sucesión, indica predominio de ambientes neríticos internos. II. El grupo de Lenticulina orbicularis, en la parte media de la sección, es indicativa de ambientes neríticos mediosexternos y, III. El grupo de Elphidium-Amphistegina se registró en la parte superior de la formación y caracteriza un ambiente nerítico externo típico. Los foraminíferos planctónicos están dispersos en la parte superior de la sección, con una diversidad relativamente baja, indicando segmentos de plataforma marina abierta, mientras que los segmentos más someros que intervienen en la parte inferior de la sección están caracterizados por abundancia de foraminíferos bentónicos. Con base en estos grupos y como contribución a la paleoecología y paleoambiente, la alta abundancia con baja diversidad y talla pequeña de las testas de foraminíferos bentónicos, son características indicativas de un ambiente oligotrófico con alto contenido de nutrientes y alta oxigenación, con salinidad normal durante el Mioceno temprano en la sección Bagh.

JUSTIFICATIVA E OBJETIVO: a hemorragia no período pós-operatório é de grande importância clínica e pode contribuir para o aumento da morbidade e mortalidade em pacientes submetidos à cirurgia de revascularização coronária. Nesse estudo prospectivo, randômico e duplo-cego, avaliamos o efeito da administração profilática de concentrado de fibrinogênio sobre o sangramento após cirurgia de revascularização coronária. MÉTODOS: no total, 60 pacientes submetidos à cirurgia de revascularização coronária foram randomicamente divididos em dois grupos. Os pacientes do grupo fibrinogênio receberam 1 g de concentrado de fibrinogênio 30 minutos antes da operação, enquanto os doentes do grupo controle receberam placebo. Os volumes de sangramento no pós-operatório, tempo de protrombina, tempo de tromboplastina parcial, INR, hemoglobina e hemoderivados transfundidos em ambos os grupos foram registrados. Um protocolo de conduta rigoroso para transfusão de hemácias foi usado em todos os pacientes. RESULTADOS: não houve diferenças significantes entre as infusões de concentrados de hemácias nos grupos estudados (1,0 ± 1,4 no grupo fibrinogênio e 1,3 ± 1,1 no grupo controle). O grupo fibrinogênio apresentou menos sangramento no pós-operatório (477 ± 143 versus 703 ± 179, p = 0,0001). Quinze pacientes do grupo fibrinogênio e 21 do grupo controle precisaram de infusão de concentrado de hemácias no pós-operatório (p = 0,094). Evento trombótico não foi observado durante 72 h após a cirurgia. CONCLUSÃO: profilaxia com fibrinogênio reduz o sangramento no período pós-operatório de pacientes submetidos à revascularização coronária.

BACKGROUND AND OBJECTIVES: Postoperative bleeding has a great clinical importance and can contribute to increased mortality and morbidity in patients undergoing coronary artery bypass graft surgery. In this prospective, randomized, double-blind study, we evaluated the effect of prophylactic administration of fibrinogen concentrate on post-coronary artery bypass graft surgery bleeding. METHODS: A total of 60 patients undergoing coronary artery bypass surgery were randomly divided into two groups. Patients in the fibrinogen group received 1 g of fibrinogen concentrate 30 min prior to the operation, while patients in the control group received placebo. Post-operative bleeding volumes, prothrombin time, partial thromboplastin time, INR, hemoglobin and transfused blood products in both groups were recorded. A strict red blood cell transfusion protocol was used in all patients. RESULTS: There were no significant differences between intra-operative packed red blood cells infusion in the studied groups (1.0 ± 1.4 in fibrinogen group, and 1.3 ± 1.1 in control group). Less postoperative bleeding was observed in the fibrinogen group (477 ± 143 versus 703 ± 179, p = 0.0001). Fifteen patients in the fibrinogen group and 21 in the control group required post-op packed red blood cells infusion (p = 0.094). No thrombotic event was observed through 72 h after surgery. CONCLUSION: Prophylactic fibrinogen reduces post-operative bleeding in patients undergoing coronary artery bypass graft.

JUSTIFICACIÓN Y OBJETIVOS: la hemorragia en el período postoperatorio es de gran importancia clínica y puede contribuir al aumento de la morbimortalidad en pacientes sometidos a cirugía de revascularización del miocardio. En este estudio prospectivo, aleatorizado y doble ciego, evaluamos el efecto de la administración profiláctica del concentrado de fibrinógeno sobre el sangrado después de la cirugía de revascularización del miocardio. MÉTODOS: en total, 60 pacientes sometidos a cirugía de revascularización del miocardio fueron aleatoriamente divididos en 2 grupos. Los pacientes del grupo fibrinógeno recibieron 1 g de concentrado de fibrinógeno 30 min antes de la operación, mientras que los del grupo control recibieron placebo. Los volúmenes de sangrado en el postoperatorio, tiempo de protrombina, tiempo de tromboplastina parcial, INR, hemoglobina y hemoderivados transfundidos en ambos grupos fueron registrados. En todo los pacientes se usó un protocolo de conducta riguroso para la transfusión de hematíes. RESULTADOS: no hubo diferencias significativas entre las infusiones de concentrados de hematíes en los grupos estudiados (1 ± 1,4 en el grupo fibrinógeno y 1,3 ± 1,1 en el grupo control). El grupo fibrinógeno presentó menos sangrado en el postoperatorio (477 ± 143 versus 703 ± 179, p = 0,0001). Quince pacientes del grupo fibrinógeno y 21 del grupo control necesitaron infusión de concentrado de hematíes en el postoperatorio (p = 0,094). Ningún evento trombótico fue observado durante 72 h después de la cirugía. CONCLUSIÓN: la profilaxis con fibrinógeno reduce el sangrado en el período postoperatorio de pacientes sometidos a revascularización del miocardio.