Imaging Study of Vesicoureteral Reflux

Different radiologic and radionuclide cystography studies have been suggested todetect and follow up vesicoureteral reflux (VUR) in children, with conflicting results.Conventional voiding cystourethrography seems the preferred method to evaluateurinary tract abnormality, voiding dysfunction, and accurate grading of VUR. However,radioisotopic cystography is a preferred method to evaluate VUR in women, patientswithout voiding dysfunction, and re-evaluate VUR

Comparison of the Frequency and Complications of Inappropriate Antidiuretic Hormone Secretion in Patients with Septic and Aseptic Meningitis

ObjectiveDue to the high prevalence of syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH). This study was carried out to evaluate the prevalence and relevant parameters of SIADH in children with septic and aseptic memingitis hospitalized at Kashan Shahid Beheshti Hospital between 1996 and 2006.Materials & MethodsThis descriptive study was conducted on 230 patients with meningitis hospitalized in the pediatric wards of Kashan Shahid Beheshti Hospital between 1996 and 2006. Relevant information (age, gender, type of meningitis, serum sodium and potassium, urine specific gravity (USG), blood sugar, blood urea nitrogen, serum creatinin, hydration condition) was collected from patients' records. Data was analyzed using Mann-Whitney and K2 tests.ResultsOut of 230 patients with meningitis, 33 had incomplete records and only 197 patients were recruited for this study. Sixty eight cases (34.5%) suffered from SIADH. It was more frequent among 1-2 year old  children.According to this research, SIADH was diagnosed in 57% of the 121 patients with hyponatremia, 58.7% of the 167 patients with USG > 1.004, 74% of the 93 patients with serum osmolity < 280 mOs/L and 100% of the patients with BUN < 10 mg%.ConclusionDue to the high prevalence of SIADH in septic and aseptic meningitis and its complication, it is recommended to restrict fluid therapy and monitor serum sodium, urine specific gravity and other diagnostic tests for SIADH.Keywords: Hyponatremia; Meningitis; SIADH, Septic, Asepti

CD11bhigh B Cells Increase After Stroke and Regulate Microglia: CD11bhigh B Cells Increase After Stroke and Regulate MG

Recent studies have highlighted the deleterious contributions of B cells to post-stroke recovery and cognitive decline. Different B cell subsets have been proposed based on expression levels of transcription factors (e.g. T-bet) as well as specific surface proteins. CD11b (α-chain of integrin) is expressed by several immune cell types and is involved in regulation of cell motility, phagocytosis, and other essential functions of host immunity. Although B cells express CD11b, the CD11bhigh subset of B cells has not been well characterized, especially in immune dysregulation seen with aging and after stroke. Here, we investigate the role of CD11bhigh B cells in immune responses after stroke in young and aged mice. We evaluated the ability of CD11bhigh B cells to influence pro- and anti-inflammatory phenotypes of young and aged microglia (MG). We hypothesized that CD11bhigh B cells accumulate in the brain and contribute to neuroinflammation in aging and after stroke. We found that CD11bhigh B cells are a heterogeneous subpopulation of B cells, predominantly present in naïve aged mice. Their frequency increases in the brain after stroke in young and aged mice. Importantly, CD11bhigh B cells regulate MG phenotype and increase MG phagocytosis in both ex vivo and in vivo settings, likely by production of regulatory cytokines (e.g., TNF-α). As both APCs and adaptive immune cells with long-term memory function, B cells are uniquely positioned to regulate acute and chronic phases of the post-stroke immune response, and their influence is subset-specific

شیردهی در زمان ابتلا به کوید 19 : شیردهی در زمان ابتلا به کوید 19

The pandemic of COVID-19 and the subsequent social distancing led to a lot of changes in the management of breastfed infant. Some protocols suggested separating the infected mothers from their neonates. Others, however, supported breastfeeding as a safe method with appropriate precautions. Considering that breastfeeding improves the emotional relationship between mother and baby, increases the quality of breastfeeding, reduces maternal stress and has a proven role in the health of mother and infant, it is very important to understand the impact of pandemic upon the ability to breastfeed. Studies have shown that in many mothers, there are numerous barriers stemming from social distancing, and in some cases, with some stopped breastfeeding against the mother desire. The World Health Organization (WHO) supports immediate post-partum mother-infant contact .Although many countries have followed WHO guidelines, other countries implemented infection prevention and control policies by post-partum separation and prohibit breastfeeding or proving expressed breast milk.  Up to data given from studies of COVID-19, it is suggestive of potentially milder course of disease among children, although the risk for severe disease in infancy remains. It is clear the separation causes irreparable harms including disrupting breastfeeding and limiting its protection against of infectious diseases, and may even lead to replace of breastfeeding by other items. Moreover it doesn’t ensure lower viral exposure during hospitalization and post-discharge. Generally, conservative policies for infected mothers and their infants may lead to excess preventable illnesses in infants. Given the challenges ahead  In this study, we reviewed numerous articles on the benefits and disadvantages of breastfeeding in infected mothers. And, considering the benefits of breastfeeding, it is recommended to continue breastfeeding by special attention to the protocols.همه گیری جهانی کوید 19 و فاصله گذاری اجتماعی متعاقب آن منجر به تغییرات فراوانی در مدیریت نغذیه نوزادان با شیر مادر شد و شیردهی مستقیم مادران مبتلا به کوید به نوزادانشان با تردیدهایی مواجه شد. برخی از پروتکل ها جداسازی مادر مبتلا از نوزاد خود را پیشنهاد دادند . در حالی که برخی دیگر شیردهی مادرمبتلا به نوزادش را با رعایت احتیاطات بهداشتی ایمن می دانستند. با نظر به اینکه شیردهی باعث بهبود ارتباط عاطفی مادر و نوزاد و افزایش کیفیت شیردهی و کاهش استرس مادر می شود و در سلامت مادر و نوزاد نیز نقش اثبات شده ای دارد فهم تاثیرات همه گیری بر روی توانایی شیردهی مادران مبتلا بسیار اهمیت دارد. در مطالعات انجام شده مشخص شد که در بسیاری از مادران موانع بیشماری ناشی از فاصله گذاری همه گیری ایجاد شده است و حتی در مواردی منجر به توقف شیردهی علیرغم تمایل مادر شده است. سازمان جهانی بهداشت (WHO) تماس مادر و نوزاد و شروع شیردهی را بلافاصله بعد از تولد پیشنهاد می کند. علیرغم اینکه بسیاری کشورها از شیوه نامه های WHO  پیروی می کنند، سایر کشورها سیاست های کنترل و پیشگیری ازعفونت را به صورت جداسازی مادر و نوزاد پس از زایمان و محدود کردن شیردهی مستقیم و یا تدارک استفاده از شیر دوشیده شده مادر اجرا می کنند. بر اساس داده های حاصل از مطالعات کوید 19 مشخص شده که دوره بیماری در اطفال خفیف تراست هرچند احتمال بالقوه بیماری شدید در نوزادان وجود دارد. آنچه واضح است جداساری مادر و نوزاد آسیب های جبران ناپذیری از جمله قطع شیردهی و کاهش ایمنی نوزاد در برابر بیماری های عفونی را در پی دارد و حتی می تواند باعث جایگزینی شیرمادر یا سایر موارد شود ضمن اینکه جداسازی کاهش مواجهه با ویروس طی بستری در بیمارستان و پس از ترخیص را تضمین نمی کند. درمجموع سیاست های محافظه کارانه برای مادران مبتلا و نوزادانشان ممکن است باعث ازیاد بیماری های قابل پیشگیری در نوزادان گردد. با توجه به آنچه گفته شد در این مقاله مطالعات انجام شده در زمینه فواید و مضرات شیردهی مادران مبتلا مورد بررسی قرار گرفت و توصیه می شود با توجه به مزایای تغذیه با شیر مادر ، با رعایت پروتکل های بهداشتی شیردهی ادامه یابد

CD11b B Cells Increase after Stroke and Regulate Microglia

Recent studies have highlighted the deleterious contributions of B cells to post-stroke recovery and cognitive decline. Different B cell subsets have been proposed on the basis of expression levels of transcription factors (e.g., T-bet) as well as specific surface proteins. CD11b (α-chain of integrin) is expressed by several immune cell types and is involved in regulation of cell motility, phagocytosis, and other essential functions of host immunity. Although B cells express CD11b, the CD11b subset of B cells has not been well characterized, especially in immune dysregulation seen with aging and after stroke. Here, we investigate the role of CD11b B cells in immune responses after stroke in young and aged mice. We evaluated the ability of CD11b B cells to influence pro- and anti-inflammatory phenotypes of young and aged microglia (MG). We hypothesized that CD11b B cells accumulate in the brain and contribute to neuroinflammation in aging and after stroke. We found that CD11b B cells are a heterogeneous subpopulation of B cells predominantly present in naive aged mice. Their frequency increases in the brain after stroke in young and aged mice. Importantly, CD11b B cells regulate MG phenotype and increase MG phagocytosis in both ex vivo and in vivo settings, likely by production of regulatory cytokines (e.g., TNF-α). As both APCs and adaptive immune cells with long-term memory function, B cells are uniquely positioned to regulate acute and chronic phases of the post-stroke immune response, and their influence is subset specific

Evaluation of mobile phone-based tele-monitoring of cystic fibrosis patients during the COVID-19 pandemic: A 3-year experience in Iran

Background: Telemedicine has been used for cystic fibrosis (CF) in a wide range of signs and symptoms even before the COVID 19 pandemic, however, little is known about the health consequences and use of specific health care for cystic CF. This study aimed to evaluate the evolution of clinical trends and data related to mobile based monitoring activities in CF patients at home for 3 years. Methods: This is a semi experimental single group study. Forty five CF patients under 7 years' old who were referred to the Masih Daneshvari Hospital between 2018 and 2021 were selected. A mobile phone_based customized Short Message Service (SMS) application used to monitor patients. Remotely monitored variables included the amount and color of sputum, cough, wheezing, and shortness of breath at rest. SPSS using Chi square and Friedman tests. Results: The condition of patients based on the number and type of cough increased sputum, decreased appetite, fatty stool, fever and dyspnea, headache, noninvasive ventilation, and drug comfortably remained almost unchanged in the study of the 1st, 2nd, and 3rd years, and the studied parameters did not show a significant difference (P > 0.05). Of course, the number of outpatient visits decreased significantly (P value: 0.02). The respiratory rate and arterial oxygen saturation variables were almost the same in three consecutive annual measurements (P values: 0.544 and 0.639, respectively). Conclusion: Telemedicine is a method that is useful in the follow up of chronic diseases such as CF and improves the quality of life and reduces the deterioration of lung function; therefore, there is less need for invasive treatments in the long run, and a fundamental change in referral motivation brings to the hospital