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

Hearing screening following treatment of neonates in NICU

Background: Advances in perinatal medicine have increased the survival rate of infants admitted to neonatal intensive care unit (NICU). Many perinatal conditions may also cause hearing impairment. Early detection of hearing loss by screening and appropriate intervention are critical to speech, language and cognitive development. The aim of this study was to determine the rate of hearing damage in neonates admitted to NICU in Amirkola Children's Hospital, Babol, Iran. Methods: This is a prospective cross-sectional, descriptive analytic study, carried out from March 2003 to April 2004. 330 neonates were screened first by Transient Evoked Otoacoustic Emissions (TEOAE) (Echocheck, Otodynamics Ltd, England), and if failed, by Auditory brainstem response (ABR) (Bera 2 Hortman Version, Beyer Dynamic Dt-48, Germany). ABR was performed with 40 db hearing level click stimulus to each ear. Data was analyzed by SPSS software using T-test and Fisher exact test. Findings: 58% of 330 NICU patients were born preterm and the rest in term. 24 neonates (7.3%) failed on TEOTE test and were referred for ABR. Before ABR testing 8 neonates died and 4 neonates had conductive hearing loss (otitis media). Finally 7 (2.1%) developed permanent hearing loss. Conclusions: Findings of this study showed that 7.3% of NICU patients failed on TEOTE and 2.1% had permanent hearing loss on ABR examination. Based on these findings, we recommend hearing screening of high risk neonates admitted to NICU

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

The Ability of Watercress (Nasturtiumofficinale) and Pennyroyal (Menthapulegium) in Clean up Excess Nitrate and Phosphate of Water

Introduction: There is necessary to clean up the nitrate and phosphate from surface waters before effluence of them to environment and eutrophication formation because of water health importance and considering to nitrate and phosphate consequences. Nitrate and ammonium as the - forms of inorganic and nitrogen have been subjected to the center of issues related to environment pollutants and water resources in a long time. The nitrate is more important than other inorganic nitrogen forms such as ammonium because of various reasons such as high dynamics and causing diseases such as some of digestion system and lymph nodes cancers in adults and methemoglobinemia in infants. Therefore the maximum concentration of this ion in drinking water has been determined as 45 mg.Lit-1 by WHO. Regarding the importance of the water health and the complications due to existence of some compounds such as nitrate and phosphate, in this experiment, the possibility of elimination or decreasing excess nitrate and phosphate from water in hydroponic conditions using of two watercress and pennyroyal plants was evaluated. Watercress(Nasturtiumofficinale) and pennyroyal (Menthapulegium)were selected because of some properties such as adaptability with the most climates of Iranamd less requirements care. Materials and Methods: Two RCD factorial experiments were carried out to evaluate the ability of watercress and pennyroyal to biosorption of nitrate and phosphate from polluted water in hydroponic conditions. First factor was plant species including watercress and pennyroyal. Second factor included nitrate (50, 100, 150 Mg/L) and phosphate (5, 10, 15 Mg/L) in first and second experiment respectively.The final concentrations of nitrate and phosphate in water was measured using spectrophotometer in wavelength of 410 nm and 690 nm by sulphatebrucine and chloride methods , respectively, which are mentioned in Standard Methods for the Examination of Water and Wastewater. At the end of the each experiment, watercress and pennyroyal plants were brought out from the pots carefully and their roots and shoots were separated. Roots and shoots were placed in aluminum foil separately and were dried by oven method (50°C and 48 h). The weights of dried samples were measured by a digital balance scale (0.001 gr accuracy). Three accumulation indices including Bio-concentration Factor, Translocation Factor and Tolerance Index were calculated by measuring of nitrate and phosphate accumulation in roots and shoots Results and Discussion: According to the results, root phosphate accumulation in two plants was different significantly (p ≤ 0.05). Also, the level values of nitrate and phosphate were resulted to their root accumulation significantly. In this regard, the phosphate accumulation in watercress root changed to 10 mg. Lit-1 significantly and reached to 4.3 mg.Kg-1 dry weight in this concentration. While for pennyroyal, there was no significant increasing in roots phosphate accumulation when its concentration was increased in medium (p ≤ 0.05). Although phosphate accumulation was difference between the two plants in root and shoots, there was similar the alteration of phosphor bioconcentration trend. Because increasing of phosphate concentration resulted in significant decreasing of this index. Whilst both of watercress and pennyroyal accumulated high amount of nitrate and phosphate, quantity of accumulation in shoots was higher than of roots. Consequently, nitrate translocation factor was 1.3 in watercress and 1.07 in pennyroyal, and phosphor translocation factor was 1.07 and 0.94 in watercress and pennyroyal respectively. Conclusions: Results indicated that two plants were pollutants purified of nitrate and phosphate (The nitrate translocation factors were 1.3 and 1.07 in watercress and pennyroyal and the phosphate translocation factors were 1.07 and 094 in watercress and pennyroyal, respectively). Generally, it was found that watercress and pennyroyal have extractive behavior completely about nitrate and phosphate. Because of the high ability of these plants in biosorption of phosphate and nitrate, with recovery of nitrogen and phosphorus cycle, they can be used as organic resources of nitrogen and phosphor supply in agricultural soil and prevent from entrancing them to seas. It is more important about phosphate, which has slowly cycle. Therefore two main roles for watercress and pennyroyal in aquatic ecosystems are expected. First, perform as bio-filter and returning the nitrogen and phosphor from surface water or wastewater for preventing the environmental pollution and second as secondary saleable or utilizable crop such as green manure and so on

Halothane induced hepatitis: a case report

"nBackground: Acute hepatitis is upon serious complications of halothane usage, can be associated with 50% mortality in severe cases. Use of halothane as inhalational anesthetic or use of it for maintenance of anesthesia is restricted/ prohibited in USA and most European countries. The occurrence of icterus and elevated liver enzymes after halothane anesthesia may be due to the drug induced hepatitis. "nCase report: we report a 28 year old woman with acute hepatitis after cesarean section under halothane anesthesia, fortunately discharged to home 40 days after that. Other causes of hepatitis became role out in the patient. "nResults: The usage of halothane should be restricted/ prohibited in our country because of its potentially serious and fatal complications and so existence of more safe but expensive alternatives

Pulmonary function testing in cement transport workers at incheh borun border, Northeast of Iran

Background: The aim of this study was to evaluate respiratory problems via pulmonary function testing in cement transport workers at Incheh Borun border in northeast of Iran in 2016. Methods: The study was conducted on 358 male workers. All subjects were evaluated for respiratory symptoms via pulmonary function testing and completion of the American Thoracic Society questionnaire. Results: Mean age of workers was 34.8±12.87 yr (age range 16-79 yr). Mean duration of employment was 6.1±4.36 yr. Most workers (75.4) were illiterate or had elementary education. In addition, 56 (15.6) subjects were smokers. Only three individuals (0.3) had obstructive pattern. There was a significant relationship between age of workers and frequency of respiratory problems (P<0.05). Conclusion: It is necessary to educate the workers about the health and safety regulations and use of personal protective equipment in workplace. In addition, periodic evaluation of respiratory function could help protect workers from developing occupational diseases. © 2019, Iranian Journal of Public Health. All rights reserved

Investigating the relationship between the number and activity of natural killer cells with increased cytomegalovirus and CMV disease after kidney transplantation

Background: Cytomegalovirus (CMV) infections caused by the cytomegalovirus are one of the most common problems in patients after kidney transplant. We examined the association of the relationship between the number and activity of natural killer cells with increased cytomegalovirus and its related disease after kidney transplantation.Material and methods: In this analytical study, 58 new transplant patients in the Labbafinejad Hospital, who did not have any evidence of CMV infection, were evaluated based on the number and percentage of CD56+/16+, CD56+/16-, and CD69+ Natural Killer (NK) cells.Results: The results of this study showed that CD16+ and CD56+ cells in the group of CMV Ag-positive patients are less than negative patients (p = 0.003) and the difference between the two groups are significant (p = 0.01). However, CD69+ cells did not differ significantly between the two groups (p = 0.1). Moreover, the absolute number of CD16+ and CD56+ cells declined significantly after infection with CMV unlike the CMV Ag - group(p = 0.003). Discussion: These results indicate that kidney transplant patients suffering from CMV infection after transplantation have a significantly reduced total number of NK cells. On the other hand, a slight decrease in the number of NK subgroups was observed with an increase in the peak serum levels of cyclosporine. As a consequence of these findings, it can be assumed that more dosage and a higher level of the drug will result in more severe immunosuppression and, consequently, increased susceptibility to CMV infections. Thus, taking the right dose of the drug would prevent viral infections and immune system from over-activation