Analysis of the factors related to mortality in patients with primary brain and central nervous system tumors

BACKGROUND: The present study aimed to assess the factors associated with the mortality of patints with brain tumor surgery at Be’sat Hospital in Sanandaj, Kurdistan, Iran.METHODS: In this prospectively cross-sectional study, 108 patients diagnosed with brain tumor and followed by a surgery during April to December of 2014 were recruited. Eighteen cases were excluded from the study due to lack of information about their treatment outcomes. Patients’ information including age, gender, tumor type, tumor location, type of treatment, and extent of resection was collected by a checklist. Clinical outcome of the patients in six months after surgery was determined through phone calling to patients. All analyses conducted in SPSS software using logistic regression.RESULTS: Forty-seven (52.2%) of the studied subjects were women. The age of cases ranged from 3 to 83 years with total mean of 43.4 ± 21.9 years. In six months after treatment, 41 (45.6%) of the treated patients died. After excluding 9 children from final analysis and modeling the data by logistic regression, statistically significant associations were observed between death from central nervous system (CNS) tumor and male gender [odds ratio (OR): 5.25, 95% confidence interval (CI): 1.38–21.99], higher age (OR: 1.07, 95% CI: 1.02–1.13), partial vs. total resection (OR: 20.24, 95% CI: 1.21–337.51), and high malignant potential tumors (OR: 14.77, 95% CI: 4.85–45.02).CONCLUSION: The results showed that both demographic (advanced age and male gender) and clinical factors (high malignant potential tumors and partial removal of tumor) related to the worse outcome in patients with primary CNS tumors during six months after surgery

Analysis of the factors related to mortality in patients with primary brain and central nervous system tumors

BACKGROUND: The present study aimed to assess the factors associated with the mortality of patints with brain tumor surgery at Be’sat Hospital in Sanandaj, Kurdistan, Iran. METHODS: In this prospectively cross-sectional study, 108 patients diagnosed with brain tumor and followed by a surgery during April to December of 2014 were recruited. Eighteen cases were excluded from the study due to lack of information about their treatment outcomes. Patients’ information including age, gender, tumor type, tumor location, type of treatment, and extent of resection was collected by a checklist. Clinical outcome of the patients in six months after surgery was determined through phone calling to patients. All analyses conducted in SPSS software using logistic regression. RESULTS: Forty-seven (52.2%) of the studied subjects were women. The age of cases ranged from 3 to 83 years with total mean of 43.4 ± 21.9 years. In six months after treatment, 41 (45.6%) of the treated patients died. After excluding 9 children from final analysis and modeling the data by logistic regression, statistically significant associations were observed between death from central nervous system (CNS) tumor and male gender [odds ratio (OR): 5.25, 95% confidence interval (CI): 1.38–21.99], higher age (OR: 1.07, 95% CI: 1.02–1.13), partial vs. total resection (OR: 20.24, 95% CI: 1.21–337.51), and high malignant potential tumors (OR: 14.77, 95% CI: 4.85–45.02). CONCLUSION: The results showed that both demographic (advanced age and male gender) and clinical factors (high malignant potential tumors and partial removal of tumor) related to the worse outcome in patients with primary CNS tumors during six months after surgery

Validation of Urinary Glycosaminoglycans in Iranian patients with Mucopolysaccharidase type I: The effect of urine sedimentation characteristics

How to Cite This Article:Abdi M, Khatami Sh, Hakhamaneshi MS, Alaei MR, Azadi NA, Zamanfar D, Taghikhani M.Validation of Urinary Glycosaminiglycans in Iranian Patients with Mucopolysaccharidose Type I: The Effect of Urine Sedimentation Characteristics. Iran J Child Neurol. 2014; 8(4):39-45. AbstractObjectiveThe first line-screening test for mucopolysaccharidosis is based on measurement of urinary glycosaminoglycans. The most reliable test for measurement of urine glycosaminoglycans is the 1,9-dimethyleneblue colorimetric assay. Biological markers are affected by ethnical factors, for this reason, the World Health Organization recommends that the diagnostic test characteristics should be used to determine results for different populations. This study determines the diagnostic value of 1,9-dimethyleneblue tests for diagnosis of mucopolysaccharidosis type I patients in Iran.Materials & Methods In addition to routine urine analysis, the qualitative and quantitative measurements of urine glucosaminoglycans were performed with the Berry spot test and 1,9-dimethyleneblue assay. Diagnostic values of the tests were determined using the ROC curve.ResultsUrine total glycosaminoglycans were significantly higher in male subjects than in female subjects. Glycosaminoglycan concentration was markedly decreased in specimens with elevated white blood cell and epithelial cells count. Using a cut-off level of 10.37 mg/g creatinine, sensitivity, and specificity were 100% and 97.22%, respectively, for a 1,9-dimethyleneblue colorimetric assay.ConclusionUrine glycosaminoglycans concentration significantly differs in our studied population. In addition to determine diagnostic validity of the 1,9-dimethyleneblue test, our results demonstrate the usefulness of measuring glycosaminoglycans for early screening of mucopolysaccharidosis type I Iran. ReferencesJackson RL, Busch SJ, Cardin AD. Glycosaminoglycans: molecular properties, protein interactions, and role in physiological processes. Physiological reviews. 1991 Apr;71(2):481-539.Ghaderi S. The biochemistry base of mucopolysaccharidoses and approach to. Genetics in the 3rd millennium. [Educational]. 2006;4(1):711-22.Mizumoto S, Ikegawa S, Sugahara K. Human genetic disorders caused by mutations in genes encoding biosynthetic enzymes for sulfated glycosaminoglycans. The Journal of biological chemistry. 2013 Apr 19;288(16):10953-61.Salbach J, Rachner TD, Rauner M, Hempel U, Anderegg U, Franz S, et al. Regenerative potential of glycosaminoglycans for skin and bone. Journal of molecular medicine (Berlin, Germany). 2012 Jun;90(6):625-35.Coppa GV, Catassi C, Gabrielli O, Giorgi PL, Dall’Amico R, Naia S, et al. Clinical application of a new simple method for the identification of mucopolysaccharidoses. Helvetica paediatrica acta. 1987 Jun;42(5-6):419-23.Fuller M, Meikle PJ, Hopwood JJ. Glycosaminoglycan degradation fragments in mucopolysaccharidosis I. Glycobiology. 2004 May;14(5):443-50.Fuller M, Rozaklis T, Ramsay SL, Hopwood JJ, Meikle PJ. Disease-specific markers for the mucopolysaccharidoses. Pediatric research. 2004 Nov;56(5):733-8.Blau N, Duran M, Gibson K. Laboratory Guide to the Methods in Biochemical Genetics. First edition ed: Springer-Verlag Berlin Heidelberg; 2008. pp287-324.Dorfman A, Matalon R. The Hurler and Hunter syndromes. The American journal of medicine. 1969 Nov;47(5):691-707.Fratantoni JC, Hall CW, Neufeld EF. Hurler and Hunter syndromes: mutual correction of the defect in cultured fibroblasts. Science (New York, NY. 1968 Nov 1;162(3853):570-2.Fratantoni JC, Hall CW, Neufeld EF. The defect in Hurler and Hunter syndromes. II. Deficiency of specific factors involved in mucopolysaccharide degradation. Proceedings of the National Academy of Sciences of the United States of America. 1969 Sep;64(1):360-6.Fratantoni JC, Neufeld EF, Uhlendorf BW, Jacobson CB. Intrauterine diagnosis of the hurler and hunter syndromes. The New England journal of medicine. 1969 Mar 27;280(13):686-8.Chamoles NA, Blanco MB, Gaggioli D, Casentini C. Hurler-like phenotype: enzymatic diagnosis in dried blood spots on filter paper. Clinical chemistry. 2001 Dec;47(12):2098-102.Nor A, Zabedah MY, Norsiah MD, Ngu LH, Suhaila AR. Separation of sulfated urinary glycosaminoglycans by high-resolution electrophoresis for isotyping of mucopolysaccharidoses in Malaysia. The Malaysian journal of pathology. 2010 Jun;32(1):35-42.De Muro P, Faedda R, Formato M, Re F, Satta A, Cherchi GM, et al. Urinary glycosaminoglycans in patients with systemic lupus erythematosus. Clinical and experimental rheumatology. 2001 Mar-Apr;19(2):125-30.Berry HK, Spinanger J. A paper spot test useful in study of Hurler’s syndrome. The Journal of laboratory and clinical medicine. 1960 Jan;55:136-8.Pennock CA, White F, Murphy D, Charles RG, Kerr H. Excess glycosaminoglycan excretion in infancy and childhood. Acta paediatrica Scandinavica. 1973 Sep;62(5):481-91.Berman ER, Vered J, Bach G. A reliable spot test for mucopolysaccharidoses. Clinical chemistry. 1971 Sep;17(9):886-90.Pennock CA. A review and selection of simple laboratory methods used for the study of glycosaminoglycan excretion and the diagnosis of the mucopolysaccharidoses. Journal of clinical pathology. 1976 Feb;29(2):111-23.Chan RW, Szeto CC. Advances in the clinical laboratory assessment of urinary sediment. Clinica chimica acta; international journal of clinical chemistry. 2004 Feb;340(1-2):67-78.Fogazzi GB, Garigali G. The clinical art and science of urine microscopy. Curr Opin Nephrol Hypertens. 2003 Nov;12(6):625-32.Berry HK. Screening for mucopolysaccharide disorders with the Berry spot test. Clinical biochemistry. 1987 Oct;20(5):365-71.de Jong JG, Hasselman JJ, van Landeghem AA, Vader HL, Wevers RA. The spot test is not a reliable screening procedure for mucopolysaccharidoses. Clinical chemistry. 1991 Apr;37(4):572-5.Mabe P, Valiente A, Soto V, Cornejo V, Raimann E. Evaluation of reliability for urine mucopolysaccharidosis screening by dimethylmethylene blue and Berry spot tests. Clinica chimica acta; international journal of clinical chemistry. 2004 Jul;345(1-2):135-40.Mahalingam K, Janani S, Priya S, Elango EM, Sundari RM. Diagnosis of mucopolysaccharidoses: how to avoid false positives and false negatives. Indian J Pediatr. 2004 Jan;71(1):29-32.de Jong JG, Wevers RA, Laarakkers C, Poorthuis BJ. Dimethyl methylene blue-based spectrophotometry of glycosaminoglycans in untreated urine: a rapid screening procedure for mucopolysaccharidoses. Clinical chemistry. 1989 Jul;35(7):1472-7.Panin G, Naia S, Dall’Amico R, Chiandetti L, Zachello F, Catassi C, et al. Simple spectrophotometric quantification of urinary excretion of glycosaminoglycan sulfates. Clinical chemistry. 1986 Nov;32(11):2073-6.Byers S, Rozaklis T, Brumfield LK, Ranieri E, Hopwood JJ. Glycosaminoglycan accumulation and excretion in the mucopolysaccharidoses: characterization and basis of a diagnostic test for MPS. Molecular genetics and metabolism. 1998 Dec;65(4):282-90.Carson NA, Neill DW. Metabolic abnormalities detected in a survey of mentally backward individuals in Northern Ireland. Archives of disease in childhood. 1962 Oct;37:505-13.Huang KC, Sukegawa K, Orii T. Screening test for urinary glycosaminoglycans and differentiation of various mucopolysaccharidoses. Clinica chimica acta; international journal of clinical chemistry. 1985 Sep 30;151(2):147-56.Chih-Kuang C, Shuan-Pei L, Shyue-Jye L, Tuen-Jen W. MPS screening methods, the Berry spot and acid turbidity tests, cause a high incidence of false-negative results in sanfilippo and morquio syndromes. Journal of clinical laboratory analysis. 2002;16(5):253-8.Gallegos-Arreola MP, Machorro-Lazo MV, Flores-Martinez SE, Zuniga-Gonzalez GM, Figuera LE, Gonzalez-Noriega A, et al. Urinary glycosaminoglycan excretion in healthy subjects and in patients with mucopolysaccharidoses. Archives of medical research. 2000 Sep-Oct;31(5):505-10.Piraud M, Maire I, Mathieu M. Pitfalls of screening for mucopolysaccharidoses by the dimethylmethylene blue test. Clinical chemistry. 1993 Jan;39(1):163-4.Whitley CB, Spielmann RC, Herro G, Teragawa SS. Urinary glycosaminoglycan excretion quantified by an automated semimicro method in specimens conveniently transported from around the globe. 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Diagnostic value of cystatin C for diagnosis of early renal damages in type 2 diabetic mellitus patients: The first experience in Iran

Background: Diabetic nephropathy (DN) is one of the most important complications of diabetes mellitus. Now-a-days, cystatin C (CysC) is introduced as a new marker for diagnosis of renal damages; however, use of this marker in clinical laboratories is still controversial. The present study was aimed to evaluate the diagnostic value of serum CysC for early detection or monitoring treatment of kidney damages in the Kurdish people with type 2 diabetes mellitus. Materials and Methods: Glomerular filtration rate (GFR) was estimated by Modification of Diet in Renal Disease formula. Serum CysC and urine microalbumin were also measured in 126 diabetic and healthy subjects. Blood glycated hemoglobin (Hb) also measured in all healthy and diabetic patients. Two independent samples t-test, Mann-Whitney U-test, one-way ANOVA, and Kruskal-Wallis test, as well as Pearson/Spearman correlation coefficient statistical tests were used as appropriate. Results: Serum CysC was higher (1312.41 ng/ml) in diabetic patients with GFR <60 ml/min than other subjects (993.25 ng/ml) (patients with normal kidney function and healthy subjects). A borderline significant correlation between CysC and estimating GFR (rs = −0.16, P = 0.05) but highly significant with microalbumin (rs = 0.22, P = 0.014) was observed. Serum CysC sensitivity, negative and positive predictive values were 100 and 4%. Conclusion: CysC cover variation of GFR and urine microalbumin, but it cannot be used as a surrogating marker of glycated Hb. According to our results, it seems that serum CysC is a useful marker for screening of DN; but it cannot be used for monitoring of treatment in diabetic patients

Prevalence of Workplace Violence of Emergency Medical Staff and Relevant Factors in Sanandaj, Iran in 2016

Background & Aim: In the past years, workplace violence in the area of health has been reported with an upward trend. This study aimed to evaluate the frequency of dealing with workplace violence in emergency medical staff of Sanandaj, Iran and relevant factors. Materials & Methods: This descriptive, analytical, and cross-sectional research was conducted in the emergency medical centers of Sanandaj in 2016. Considering the limited research population, census method was applied and all 126 staff of these centers were selected. Data were collected via a self-report questionnaire. In addition, data analysis was performed in SPSS version 20 using Chi-square and Fisher&rsquo;s exact tests. Results: In this research, 84% (95% CI=75-90) of the participants had an experience of workplace violence in the past year, 42% (95% CI=32-52) of which has been physical and 81% (95% CI=72-88) has been verbal violence. In addition, 59.4% (N=47) of the staff reported the source of violence to be the companions of patients. Moreover, 87% of the participants believed that there is no proper procedure to report workplace violence. Results were indicative of no significant relationship between workplace violence in the emergency medical staff and variables of age, marital status, work experience, and having work shift (P>0.05). Conclusion: According to the results of the study, there is an alarmingly high rate of workplace violence in the emergency medical centers of Sanandaj. This level of violence might reduce care quality and increase occupational stress. Considering the high rate of accidents in Iran and the necessity of composure for the staff, management interventions (e.g., public community education, creation of a suitable report system for the personnel and review of reports) are required to improve this area

DIAGNOSTIC UTILITY OF ADENOSINE DEAMINASE IN SERUM AND BRONCHOALVEOLAR LAVAGE FLUID FOR SCREENING LUNG CANCER IN WESTERN IRAN DIJAGNOSTI^KA KORIST ADENOZIN-DEAMINAZE U SERUMU I BRONHOALVEOLARNOM LAVA@U ZA SKRINING RAKA PLU]A U ZAPADNOM IRANU

Summary Background: This study aimed to determine adenosine deaminase (ADA) activity as a possible screening tool in lung cancer patients. Methods: Blood samples were collected from 30 subjects with positive pathological tests and 62 patients with negative pathological tests as a control group. The enzymatic activity of total ADA and its isoenzymes was determined. Results: tADA and ADA2 isoenzyme activity was significantly higher in cancerous patients compared to benign controls in serum and BAL fluid. Using a cut-off level of respectively 35.22 U/L and 31.80 U/L for BAL total ADA and ADA2, sensitivity and specificity were 100% and 81% for total ADA and 95% and 98% for ADA2. Conclusions: Adenosine deaminase may play important roles in the pathophysiology of lung cancer and because of it

Erratum to: Rapid identification of Iranian Acinetobacter baumannii strains by single PCR assay using blaOXA-51like carbapenemase and evaluation of the antimicrobial resistance profiles of the isolates

The rapid identification of relevant bacterial pathogens is of utmost importance in clinical settings. The aim of this study was to test a rapid identification technique for A. baumannii strains from Tehran Hospitals and to determine the antibiotic resistance profiles of the isolates. A hundred strains of Acinetobacter spp. grown from clinical specimens were identified as A. baumannii by conventional methods. Using PCR a blaOXA-51-like gene was detected in all A. baumannii isolates but not in other species of acinetobacter. More than half of the isolates proved resistant to a variety of antibiotics by the disk diffusion technique. The rate of resistance to gentamicin, imipenem, ampicillin-sulbactam and amikacin was determined to be 45%, 53%, 62% and 62%, respectively. Moreover, most isolates (more than 90%) showed resistance to cephalosporins. This study shows that the demonstration of the blaOXA-51-like gene is a reliable and rapid way for the presumptive identification of A. baumannii and reveals that the rate of antibiotic resistance is high in Iranian A. baumannii isolates to a variety of antibiotics

Rapid identification of Iranian Acinetobacter Baumannii strains by single PCR assay using BLAoxa-51-like carbapenemase and evaluation of the antimicrobial resistance profiles of the isolates

The rapid identification of relevant bacterial pathogens is of utmost importance in clinical settings. The aim of this study was to test a rapid identification technique for A. baumannii strains from Tehran Hospitals and to determine the antibiotic resistance profiles of the isolates. A hundred strains of Acinetobacter spp. grown from clinical specimens were identified as A. baumannii by conventional methods. Using PCR a blaOXA-51-like gene was detected in all A. baumannii isolates but not in other species of acinetobacter. More than half of the isolates proved resistant to a variety of antibiotics by the disk diffusion technique. The rate of resistance to gentamicin, imipenem, ampicillin-sulbactam and amikacin was determined to be 45%, 53%, 62% and 62%, respectively. Moreover, most isolates (more than 90%) showed resistance to cephalosporins. This study shows that the demonstration of the blaOXA-51-like gene is a reliable and rapid way for the presumptive identification of A. baumannii and reveals that the rate of antibiotic resistance is high in Iranian A. baumannii isolates to a variety of antibiotics