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Showing 5 results for Adherence
Isolation and purification of natural killer cells subpopulations using mononuclear cells
N Mosaffa , F Labibi ,
Volume 57, Issue 1 (4-1999)
Abstract
Natural Killer (NK) cells are the main lymphocyte population expressing P75 B chain of the IL-2 receptor (IL-2R). Consequently, incubation of peripheral blood lymphocytes with IL-2 induce selective activation of NK cells and results in NK activity and generation of Lymphokine activated killer (LAK) cells activity and proliferation. One of the early events during IL-2 activation of peripheral blood lymphocyte in both rodents and humans is adherence of some NK cells to plastic surface. The cells adherence to plastic after 24 hr of culture with IL-2 are almost exclusively CD56+, have the morphology large granular cells to yield a highly entiched population of activated NK cells that have been used for systemic adoptive immunotherapy. To test these hypothesis, we used highly purified population of human peripheral NK cells through the biological and nonimmunclogical phenotyping technique. Blood mononuclear cells were separated by centrifugation of ficol-hypaque gradient from normal blood donor (20-30 years age). We depleted after purification of nonadherent cells with nylonwool. We collected with rosette technique to remove cells with high affinity SRBC receptors. These cells separate in two parts A-NK and NA-NK by mononuclear celss activated supernatant media. The main objective results of this study show that the subpopulation of human NK cell which develope early adherent to plastic surface in the presence of supernatant mononuclear celss activation media was functionally more cytotoxic and killed K562 targets in single cell sytotoxicity manner and LDH activity assay than nonadherent NK cells and resting NK cells
Adherence to antiretroviral therapy and its determinants in AIDS patients: review article
Yalda A, Seyyed Alinaghi Sa, Hajiabdolbaghi M,
Volume 66, Issue 7 (10-2008)
Abstract

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 There are limited published investigations about adherence to antiretroviral and its determinants. Many determinants influence on adherence to therapy. The effects of some determinants on adherence are controversial. More studies are needed to be fulfilled about adherence and its determinants to compile strategies. Key to the success of antiretroviral therapies is the ability and willingness of HIV-positive individuals to adhere to antiretroviral regimens. There are different definitions for full adherence. In the most studies, adherence is defined as taking ≥95% of prescribed medication. Adherence rate needs to be >95% to prevent virologic failure and for complete supper-ssion. The consequences of poor adherence include not only diminished benefits for the patient, but also the public health threat of the emergence of multidrug-resistant viruses, as these resistant strains can then be transmitted from a patient to their contacts. Evaluating adherence has proven to be difficult and there is no gold standard for evaluating adherence to medication. Adherence is assessed in various ways. The most studies evaluate adherence to treatment by using patient's self report and the pill count method but these are methods known to overestimate adherence. Some determinants are associated with adherence include: age, gender, addiction specially injection drug users, alcohol consumption, depression, social support, level of education, work situation, adverse antiretroviral effects, pregnancy, type of antiretroviral drug regimen, number of pills and daily doses received, severe traumas, social and psychological factors, and relationship between clinician and patient.0


Resistant hypertension, case based approach to diagnosis and management: case report
Mohammad Taghi Najafi , Mohammad Hossein Shojamoradi , Farzanehsadat Minoo ,
Volume 78, Issue 2 (5-2020)
Abstract
Background: Resistant hypertension is defined when the blood pressure remains elevated above the therapeutic target levels despite the use of three antihypertensive agents including calcium channel blocker (CCB), renin-angiotensin system (RAS) blocker and a diuretic. These drugs should be used at maximally tolerated doses and white coat effect and non-adherence should also be excluded. In this article, by describing a case of resistant hypertension, we discuss a diagnostic and therapeutic approach to resistant hypertension.
Case Presentation: A 59 years old man, known case of diabetic nephropathy with a serum creatinine level of 1.2 mg/dL and proteinuria of about 3300 mg in 24 hours referred to Hypertension Clinic of Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, for evaluation of resistant hypertension. The patient was under treatment by losar-H, diltiazem, and furosemide, which are not appropriate combinations of antihypertensive agents. The ambulatory blood pressure monitoring (ABPM) of the patient revealed daytime and nighttime hypertension and also the non-dipping status of blood pressure. Dihydropyridine CCB was prescribed in combination with RAS blocker (Exforge 50 mg/ 160 mg) and the diuretic was changed to thiazide-like agents. In the next step, spironolactone and carvedilol were added for better control of blood pressure. The patient referred to the sleep clinic for polysomnography and evaluation of obstructive sleep apnea. Following three months prescription of these medications, ABPM revealed relatively appropriate control of blood pressure, so the average 24-hour blood pressure decreased from 157/91 mm Hg to 136/83 mm Hg.
Conclusion: The complications and mortality of hypertension would be increased dramatically in patients with resistant hypertension. So, an appropriate diagnostic and therapeutic approaches should be considered for these patients. Choosing appropriate diuretic agents would be important in the management of resistant hypertension.

Evaluating the guidelines adherence in the management of NSTE-ACS referred to shahid chamran hospital within six-month period in 2021: a brief report
Mohammad Mahdi Gholamian , Mehrnoush Dianatkhah, Mohammad Kermani-Alghoraishi, Ehsan Shirvani,
Volume 81, Issue 8 (11-2023)
Abstract
Background: The purpose of this study was to evaluate the adherence to the ESC 2020 guideline for the management of NSTE-ACS patients admitted to Shahid Chamran Cardiology Hospital affiliated to Isfahan University of Medical Sciences in 2021.
Methods: In this retrospective study which was done during April 2021 to September 2021 we reviewed the hospital documents of 239 NSTE-ACS patients, in regard to prescribed medication during the admission period in Shahid Chamran Heart Center. Guideline-adherence was evaluated according to ESC2020 guideline. Totally 18 items were evaluated including Antiplatelet (Clopidogrel, Ticagrelor, and Prasugrel) Anticoagulant (Heparin or Enoxaparin), PPI, Statin, Beta blocker, and RAAS blockers (including ACEI/ARB or MRA). In each section the selected drug and the administered dose were compared with the guideline and the guideline adherence for each part was expressed as percent.
Results: Almost complete guideline adherence was described for 12 out of 18 reviewed items (77%). However, guideline adherence in relation to the type of medicine chosen as an antiplatelet was reported to be very low, and only 1.2% of the cases received ticagrelor or prasugrel which are the guideline recommended antiplatelet agent. Additionally, most of the administered GP2b3a antagonist agents such as eptifibatide were not in accordance with the guideline (Guideline adherence 39.74%). Also, the choice of the anticoagulant agent was among the items with low guideline adherence (29.76%) and the cross-over between anticoagulants (changing heparin to enoxaparin or vice versa) which has been inhibited by the guideline was seen with high incidence in this center (78 cases).
Conclusion: The present study showed relatively high guideline adherence in the most aspects of medical management. However, compliance was reported to be low in relation to the antiplatelet selection, the choice of the anticoagulant agent, and the indication for GP2b3a antagonist use, which maybe due to the higher cost of recommended agents, and shortage of some medications and dosage forms in Iran.

Mobile applications as a new way to health: a systematic review
Negar Heidari , Fatemeh Rajati , Mojgan Rajati, Paria Heidari,
Volume 81, Issue 11 (1-2024)
Abstract

                                                                  
Background: Management of chronic diseases, such as hypertension and diabetes, requires a comprehensive long-term care plan. Adherence to self-management behaviours is crucial in improving health outcomes and quality of life for individuals living with these conditions. The research highlighted in this review study aimed to explore the potential of mobile health technology in enhancing primary and secondary prevention of chronic diseases. By providing personalized interventions, mobile applications can play a significant role in supporting individuals in the self-management of their hypertension and diabetes, ultimately leading to better disease control and improved overall well-being.
Methods: The present study is a systematic review of research examining the impact of mobile application interventions on the self-management of hypertension and diabetes. The review analyzes studies published between July 2013 to March 2023, retrieved from the PubMed and Scopus international databases using keywords such as Mobile Health, mHealth, adherence, Hypertension, High Blood Pressure, and Diabetes.
Results: A total of 1398 abstracts were found, of which 12 articles met the inclusion and exclusion criteria for this study. The research indicates that mobile health (mHealth) applications have significant potential to optimize healthcare processes and facilitate improved access to health information. These digital tools can combine various treatment methods with attractive, user-friendly solutions that allow patients to actively monitor a range of health indicators, such as diet, body weight, blood pressure, mood, and sleep patterns. By enabling this type of continuous self-monitoring, mHealth apps can empower individuals to take a more active role in managing their well-being. Additionally, these applications can facilitate greater collaboration between healthcare providers, patients, and their families, thereby enhancing the overall coordination and accessibility of care. As such, mHealth technologies can be effectively leveraged in conjunction with traditional medical services to improve health outcomes and expand access to critical health information.
Conclusion: The present study found a significant increase in mobile health app usage. To understand the real, long-term impact of this technology on health, further longitudinal studies are needed. Comprehensive research is crucial to guide the development of effective digital health interventions that can improve individual and population outcomes over time.


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