Evaluation of therapeutic response of Keloid and Hypertrophic scars to bleomycin tatto and to cryotherapy followed by intralesional triamcinolone injection

کلوئید و اسکارهایپرتروفیک بیماری هایی هستند ناشی از پاسخ غیر طبیعی پوست بدن به صدمات وارده که به علت تولید بیش ازحد بافت های فیبروس متراکم در محل ضایعه ایجاد می شوند. از بین درمان های بسیار زیاد پیشنهاد شده برای این بیماری ها، کرایوتراپی و تزریق داخل ضایعه تریامسینولون جزء متداول ترین این درمان ها است، اما هنوز موفقیت درمانی در این بیماری کامل نیست. هدف از انجام این پژوهش بررسی پاسخ درمانی کلوئید و اسکارهایپرتروفیک به تاتوی بلئومایسین و مقایسه آن با درمان معمول کرایوتراپی و تزریق داخل ضایعه تریامسینولون می باشد. بدین منظور 45 نفر از بیماران مبتلا به کلوئید و اسکارهایپرتروفیک مراجعه کننده به درمانگاه های پوست دانشگاه علوم پزشکی اصفهان بر اساس ترتیب مراجعه به دوگروه A (23 نفر) و گروه B (22 نفر) تقسیم شدند. گروه A بوسیله تاتوی بلئومایسین و گروه B بوسیله کرایوتراپی و تزریق داخل ضایعه تریامسینولون درمان شدند. درمان ها در چهار مرحله و با فواصل یک ماهه در هر دو گروه انجام شد و بیماران تا 3 ماه پس از پایان درمان پیگیری شدند. قبل و پس از درمان اندازه (شامل ضخامت و وسعت ضایعات)، علائم کلینیکی، محل و تعداد ضایعات و دیگر اطلاعات مورد نیاز ثبت و در هر گروه مقایسه گردید. پاسخ درمانی که بر اساس کاهش اندازه ضایعات نسبت به ویزیت اول تعریف شده بود، در گروه A، 14±3/88 درصد و در گروه B، 5/22±3/67 درصد به دست آمد که تفاوت معنی داری بین دوگروه مشاهده می شود (001/0P=) ضمن آنکه 69 بیماران گروه A در مقایسه با قبل از درمان بدون علامت شده بودند در حالی که تعداد کسانی که در گروه B بدون علامت شده بودند 49 درصد بود. همچنین در گروه B هر چه اندازه ضایعه بزرگتر بود پاسخ درمانی ضعیف تری به دست می آمد ولی در گروه A اندازه ضایعات تقریباً اثری در پاسخ درمانی ایجاد نکرد. نتیجه آنکه تاتوی بلئومایسین پاسخ درمانی بالائی می تواند در این بیماری ها ایجاد کند خصوصاً آنکه در ضایعات با اندازه بزرگ نیز اثر درمانی آن حفظ می شود

Increased Expression of Toll-Like Receptors 2 and 4 in Renal Transplant Recipients that Develop Allograft Dysfunction: A Cohort Study

Background: The incidence of ischemic reperfusion injury (IRI) in early phase posttransplantation and activation of toll-like receptor (TLR-2) and TLR-4 remarkably impact the outcome of a renal allograft. Objective: To investigate whether the expression of TLRs in peripheral blood mononuclear cells (PBMCs) can predict the clinical outcome of kidney allografts. Methods: We obtained blood samples from 52 renal transplant patients before transplant, and 2, 90, and 180 days post-transplantation in order to analyze the surface expressions of TLR-2 and TLR-4 on peripheral blood monocytes. The expression patterns of TLR-2 and TLR-4 were compared between patients with graft dysfunction (GD) and those with well-functioning graft (WFG). Results: Significantly different mean dynamic changes in surface expression of TLR-2, according to percentage of TLR-2(+) cells, between (the GD and WFG) groups existed at most time-points before and after renal transplantation (p=0.007) with the exception of day 2 post-transplantation. We observed significantly higher mean fluorescence intensities of TLR-2 and TLR-4 on CD14(+) cells in the GD group compared to the WFG group. This finding was particularly observed 180 days post-transplantation (p=0.001). Based on TLR-2 and TLR-4 protein expression for each step, multiple logistic regression and ROC curve analysis revealed that an increase in CD14(+) TLR-2(+) monocytes within the 90 days post-transplantaton was associated with increased risk of GD at 180 and 365 days post-transplantation odds ratio (OR)=1.27, p=0.005). Conclusion: Sequential monitoring of TLR-2 and TLR-4 expression patterns in peripheral blood monocytes appear to be prognostic and predictive biomarkers for early and late kidney allograft outcomes

Dynamic variation of kidney injury molecule-1 mRNA and protein expression in blood and urine of renal transplant recipients: a cohort study

BACKGROUND: Acute renal dysfunction still constitutes a highly significant obstacle to renal transplantation outcome. Kidney injury molecule-1 is highly upregulated in proximal tubular cells and shed into the urine and blood circulation following kidney injury. The aim of current cohort study was to evaluate the urine KIM-1 (uKIM-1) mRNA expression level and its protein concentration in blood and urine samples to determine whether sequential monitoring of KIM-1 in renal allograft recipients is a reliable biomarker for predicting the clinical status and outcome. METHODS: Both uKIM-1 mRNA expression level and the level of serum and uKIM-1 protein concentration in the 52 renal transplant recipients were respectively quantified using real-time PCR and ELISA methods at 2, 90 and 180 days after transplantation. RESULT: KIM-1 mRNA and protein expression level in the blood and urine samples of patients with graft dysfunction was significantly higher than patients with well-functioning graft on days 2, 90 and 180 after transplantation. Receiver-operating characteristic curve analysis of mRNA and protein expression levels showed that urinary and blood KIM-1 at months 3 and 6 could predict acute renal dysfunction at 6 months and 1 year after transplantation. CONCLUSION: Sequential monitoring of uKIM-1 mRNA expression level and its protein concentration in the serum and urine samples of renal transplant patients suggests that KIM-1 could be a sensitive and specific biomarker for early diagnosis and prognosis of kidney allograft injury

High expression of TIM-3 and KIM-1 in blood and urine of renal allograft rejection patients

Background-T cell immunoglobulin and mucin domain 3 (TIM-3) is involved in alloimmune and autoimmune responses, as well as tolerance induction in kidney transplantation. Kidney injury molecule-1 (KIM-1) is highly expressed in epithelial cells of the injured proximal tubule. In this study, we have investigated both urinary and blood TIM-3 mRNA expressions, urinary KIM-1 mRNA expression, and urinary and serum KIM-1 proteins in renal allograft recipients diagnosed with acute allograft rejection (AR) and chronic allograft dysfunction (CAD), as well as those with well-functioning transplants (WFG). Methods: We divided 85 patients into the following groups: AR (n = 24), CAD (n = 19), and WFG (n = 42). TIM-3 and KIM-1 mRNA expressions were quantified using real-time reverse-transcription TaqMan probe polymerase chain reaction (RT-PCR). An ELISA test was used to measure the amount of KIM-1 protein in serum and urine samples. Results: AR and CAD patients had significantly greater urinary and blood TIM-3 mRNA expressions, urinary KIM-1 mRNA expression, and urinary and serum KIM-1 proteins compared to WFG patients. Receiver operating characteristic (ROC) analysis showed that these molecules discriminated Allograft rejections from WFG. Conclusion: Quantification of TIM-3 and KIM-1 mRNA expressions, along with KIM-1 protein measurements in urine and blood could be employed as promising tools for noninvasive diagnosis of allograft dysfunction

Expression patterns of Toll like receptor (TLR)-2, TLR-4 and myeloid differentiation primary response gene 88 (MYD88) in renal transplant patients developing allograft dysfunction; a cohort study

This cohort intends to determine the sequential dynamic changes in Toll-like receptor (TLR)-4, TLR-2, and myeloid differentiation primary response gene 88 (MYD88) mRNA expressions in PBMCs and biopsy samples from kidney allograft recipients in relation to graft function. This study enrolled 52 renal transplant patients, 27 with well functioning graft (WFG) and 25 graft dysfunction (GD). Peripheral blood samples pre- and post-transplantation (days 2, 90 and 180) were collected to analyze mRNA expression levels of TLR-2, TLR-4, and MYD88 genes in relation to allograft function during one-year follow up. The mean dynamic changes of post-transplant TLR-2, TLR-4, and MYD88 mRNA expressions were significantly higher in GD compared to WFG patients (P = .001). ROC curve analysis based on glomerular filtration rate (GFR) index showed the area under curve (AUC) values for the genes: TLR-2(0.89;P < .001), TLR-4(0.86;P < .001), and MYD88(0.75;P = .003) in the third month post-transplantation for GD diagnosis. The calculated AUCs for the expressions of genes in allograft biopsies were 0.94(TLR-2), 0.95(TLR-4), and 0.98(MYD88) in the sixth month post-transplant based on pathology report (P < .001). Our results indicate that sequential monitoring of the expression patterns of TLR-2, TLR-4, and MYD88 in PBMCs and biopsy samples could be considered as predictive biomarkers for early and late kidney allograft function

The Epidemiology of Aggression and Associated Factors among Iranian Adult Population: A National survey

Background: This survey was conducted to determine the level of aggression among the Iranian adult population and underlying predisposing factors. Study design: A cross-sectional study. Methods: This cross-sectional study included 10,957 participants, involving 23 out of the 31 provinces of Iran in 2019. The outcome of interest was aggression, evaluated by the Buss & Perry aggression questionnaire. The association between aggression and 34 demographic, behavioral, social, and cultural characteristics was assessed using simple and multiple linear regression. Results: The overall mean (SD) score of aggression was 77.10 (22.53). Based on the severity of aggression, the participants were categorized into four groups as follows: 2,464 (23.1) nonaggressive, 4,692 (43.9) mild, 3,071 (28.8) moderate, and 454 (4.2) severe aggressive. Aggression was more likely to occur in people with the following characteristics: younger ages, having several siblings, lower ranks of birth, having an intimate friend of the opposite sex, having an aggressive father/mother, history of parental divorce, interest in watching action/porn movies, listening to music, history of escape from home/school, using neuropsychiatric drugs, using illicit drugs, history of suicidal thoughts/attempt, and family conflict and hostility. Aggression was less likely to occur with the following characteristics: reading, regular physical exercise, the ability to control anger, regular prayer, adherence to avoid lying, respect to other people's rights, sexual satisfaction, and attachment to parents. Conclusions: A majority of the population has some degree of aggression. Aggression is a multifactorial behavior corresponding with several demographical, social, cultural, and religious factors, some of which back to early childhood events