Glomerular hyperfiltration as predictor of cardiometabolic risk factors among children and adolescents: The childhood and adolescence surveillance and prevention of adult�v study

Background: The prevalence of glomerular hyperfiltration and chronic kidney disease is increasing worldwide in parallel with obesity hypertension epidemic. The effect of increases in glomerular filtrations (GFR) in children with metabolic syndrome has not been studied. The purpose of the present study is to investigate the relationship between GFR and cardiometabolic risk factors in a large sample of pediatric population. Methods: In this nationwide survey, 3800 participants were selected by cluster random sampling from 30 provinces in Iran. Anthropometric measures, biochemical, and clinical parameters were measured. We also measured estimated GFR (eGFR) using the recently modified Schwartz equations and other known cardiometabolic risk factors such as elevated total cholesterol, high low�density lipoprotein cholesterol (LDL�C), and obesity. Results: The response rate was 91.5 (n = 3843). The mean and standard deviation (SD) (Mean ± SD) of eGFR for girls, boys, and total population were 96.71 ± 19.46, 96.49 ± 21.69, and 96.59 ± 20 ml/min/1.73 m2, respectively. Overall, 38.7 of the participants did not have any cardiometabolic risk factor. In multivariate models, the risk of elevated systolic blood pressure (BP) (odds ratio OR: 1.48; 95% confidence interval CI: 1.08-2.02), elevated diastolic BP (OR: 1.48; 95% CI: 1.08-2.02), elevated LDL�C (OR: 1.35; 95% CI: 1.07-1.70), and obesity (OR: 1.70; 95%CI: 1.24-2.33) were significantly higher in participants with higher eGFR level than those with the lower level but not with low level of high�density lipoprotein cholesterol (OR: 0.72; 95% CI: 0.60-0.88). Conclusions: This study demonstrates an association between glomerular hyperfiltration and obesity�related hypertension in a large sample of the Iranian pediatric population, independently of other classical risk factors. © 2018 International Journal of Preventive Medicine

SET membership identification of a lightl damped flexible beam for robust control

The aim of this paper is to identify the nominal model and associated uncertainty bound of a lightly damped flexible beam in order to be utilized in robust controller design methods. Our approach is based on Set Membership theory where the system's uncertainties assumed to be unknown but bounded (UBB). Both parametric and non-parametric uncertainties have been accounted in the robust identification problem. The problem has been solved using Ellipsoidal and Parallelotopic approximation methods

The Role of Family Physician in Case Finding, Referral, and Insurance Coverage in the Rural Areas

Background: WHO suggest that family physician is the core in the world efforts for quality improvement, cost ef­fectiveness, and equity in the health care systems. This study evaluates the impact of the program on accessibility of the services, case finding, patient referral, feedback process and insurance coverage in the rural health units.Methods: This study was quasi experimental. It compared the function of four health centers and eight health houses in the last three months of year 2004 with 2008. Data extracted from the available documents in the health units. Descrip­tive and analytical analysis was performed by using SPSS software.Results: The presence of physicians in health centers were 75 and 100 percent for 2004 and 2008 respectively, this rate for midwives were 50 and 100 percent for the same years respectively. The total referral cases to the hospitals were 2676, the feedback rate was recorded in 36% of the cases. In this case the follow up rate by physicians was 0% in 2004 and 3.17% in 2008. Insurance coverage rate was 27% and 97% for 2004 and 2008 respectively within a meaningful P value range at 95% CI.‍Conclusion: The findings of this study show that the family physician program has the positive impact on function of health units in terms of availability of physicians and midwives and also insurance coverage at health centers in rural area, No impact on patient follow up and case referral rate was detected