7 research outputs found
Smoking and Second Hand Smoking in Adolescents with Chronic Kidney Disease: A Report from the Chronic Kidney Disease in Children (CKiD) Cohort Study
The goal of this study was to determine the prevalence of smoking and second hand smoking [SHS] in adolescents with CKD and their relationship to baseline parameters at enrollment in the CKiD, observational cohort study of 600 children (aged 1-16 yrs) with Schwartz estimated GFR of 30-90 ml/min/1.73m2. 239 adolescents had self-report survey data on smoking and SHS exposure: 21 [9%] subjects had “ever” smoked a cigarette. Among them, 4 were current and 17 were former smokers. Hypertension was more prevalent in those that had “ever” smoked a cigarette (42%) compared to non-smokers (9%), p\u3c0.01. Among 218 non-smokers, 130 (59%) were male, 142 (65%) were Caucasian; 60 (28%) reported SHS exposure compared to 158 (72%) with no exposure. Non-smoker adolescents with SHS exposure were compared to those without SHS exposure. There was no racial, age, or gender differences between both groups. Baseline creatinine, diastolic hypertension, C reactive protein, lipid profile, GFR and hemoglobin were not statistically different. Significantly higher protein to creatinine ratio (0.90 vs. 0.53, p\u3c0.01) was observed in those exposed to SHS compared to those not exposed. Exposed adolescents were heavier than non-exposed adolescents (85th percentile vs. 55th percentile for BMI, p\u3c 0.01). Uncontrolled casual systolic hypertension was twice as prevalent among those exposed to SHS (16%) compared to those not exposed to SHS (7%), though the difference was not statistically significant (p= 0.07). Adjusted multivariate regression analysis [OR (95% CI)] showed that increased protein to creatinine ratio [1.34 (1.03, 1.75)] and higher BMI [1.14 (1.02, 1.29)] were independently associated with exposure to SHS among non-smoker adolescents. These results reveal that among adolescents with CKD, cigarette use is low and SHS is highly prevalent. The association of smoking with hypertension and SHS with increased proteinuria suggests a possible role of these factors in CKD progression and cardiovascular outcomes
Viral infections in 47 CVID patients in allergy and immunology department of Rasool E Akram hospital in Tehran
Background: CVID is a heterogeneous primary immune deficiency with infectious,
autoimmune and autoinflamatory features. It is most common symptomatic PID in Iran, with
prevalence of 1 in 25000 to 50000 people. CVID has been divided into some phenotypes to
produce more homogenized subpopulations. CVID is not a pure Ab deficiency .and because of
both abnormalities in Tcell and innate immunity in combination with B cell dysfunction these
patients are predisposed to viral and opportunistic infections.
Method: prevalence of viral infections is reported in 47 CVID patients registered in Rasool
E Akram hospital in Tehran. Patients have been diagnosed as CVID with the PAGID-ESID
diagnostic criteria in our department or referred from other clinics for follow up and treatment.
Diagnosis of viral germs has been made by clinical signs, pathological significances and in
some cases by PCR.
Cases: 9 patients (19%) had problems with viral infections. Infections occurred befor diagnosis
of CVID in some cases or after that. Four patients (8.5 %) had problems with wart. Sever
mucocutaneus HSV infection has occurred in 3 (6 %), recurrent zona in one (2 %) and CMV
infection as colitis or pneumonitis in 3(6 %) patients. Sever progressive lethal CNS infection
with JC virus occurred in one patient.
Conclusion: evidences show that CVID is not a pure B cell defect, and we should be aware of
opportunistic and viral infections that in some cases may be fatal