Tuberculosis in renal transplant recipients in Isfahan University of Medical Sciences

سابقه و هدف : عفـونت با مایکـوباکتـریـوم توبرکولوزیس یکـی از علل مهم بیمارگنـی و مرگ و میـر در دریافتکنندگان پیوند کلیه میباشد. شیوع توبرکولوزیس در این افراد به مراتب بیشتر از افراد عادي میباشد و در کشورهاي در حال توسعهو مناطق آندمیک از نظر B.T ،باز هم شیوع آن بیشتراست. مواد و روشها: در این مطالعه که از نوع مرور پرونده بود، 700 بیمار دریافتکننده پیوند کلیه بررسی شدند و 10 مورد ابتلاي قطعی به توبرکولوزیس، از نظر اطلاعات دموگرافیک، فاصله بین پیوند کلیه تا تشخیص سل، محل درگیري، پیآمد(Outcome ،(بقا(Survival (گرافت مورد مطالعه قرار گرفتند. یافتهها: شیوع توبرکولوزیس پس از پیوند کلیه در این مطالعه 4/1 درصد بود. میانگین سن بیماران 9/37 سال و متوسط فاصله بین پیوند کلیه تا تشخیص B.T 7/15 ماه بود. شایعترین نوع درگیري، B.T برونکوپولمونري(60 درصد) و پس از آن B.T منتشر(20 درصد) و B.T مفصل هیپ(20 درصد) بود. استنتاج: شیوع B.T در بیماران پیوند کلیه بیشتر از افراد عادي است. تظاهرات آن غیرمعمول است و اثر زیادي روي سلامت فرد و عضو پیوندي دارد، در نظر داشتن بیماري و دقت و توجه کافی در پیگیري درازمدت این بیماران باعث تشخیص ودرمان صحیح و بهموقع و کاهش عوارض بیماري خواهد شد

Decoy Cell Viruria in Kidney Transplant Patients. Does it correlate with Renal Function?

Objective: BK virus (BKV) infection after kidney transplantation has been a topic of great interest in the recent decade. Prospective screening studies have revealed that BKVN is principally an early complication of renal transplantation occurring within the first post-transplant year in most cases. The aim of the present study was to observe the incidence of decoy cell viruria in renal transplant recipients. Furthermore, correlation of decoy cell viruria with graft function was assessed. Methods: This analytic cross-sectional study was conducted in the Transplant Center of Alzahra Hospital, Isfahan, Iran between Jun 2014 and June 2015. Clinical screening for polyomavirus infection was done by means of urine cytological evaluation for decoy cells. Urine samples were analyzed in three steps including 2-4 months after transplantation, three and six months later. Results: Thirty-three patients (22 male and 11 female) received kidney transplant from living donors. The average of patients' age was 41.9 +/- 12.83 (range: 20-63 years). Peritoneal and hemodialysis were used for 15.6% and 84.4% of recipients. The occurrence of decoy cell viruria at the time of enrollment, 3 and 6 months later was found in 18.2%, 10.7% and zero, respectively. Conclusion: As urine cytology is easy to perform and of low cost, it is a useful tool for the investigation of active polyoma virus infection. Moreover, the findings advocate that the presence of decoy cells along with high creatinine is a better indicator of the virus presence

DNA Methylation Pattern as Important Epigenetic Criterion in Cancer

Epigenetic modifications can affect the long-term gene expression without any change in nucleotide sequence of the DNA. Epigenetic processes intervene in the cell differentiation, chromatin structure, and activity of genes since the embryonic period. However, disorders in genes' epigenetic pattern can affect the mechanisms such as cell division, apoptosis, and response to the environmental stimuli which may lead to the incidence of different diseases and cancers. Since epigenetic changes may return to their natural state, they could be used as important targets in the treatment of cancer and similar malignancies. The aim of this review is to assess the epigenetic changes in normal and cancerous cells, the causative factors, and epigenetic therapies and treatments

National and sub-national trends of salt intake in Iranians from 2000 to 2016 : a systematic analysis

Acknowledgements The authors wish to thank all the staff at the Non-Communicable Diseases Research Center of Tehran University of Medical Sciences for their support. Funding This study was supported by Iran University of Medical Sciences (Grant Number: 9221128206).Peer reviewedPublisher PD

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic

Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021

This online publication has been corrected. The corrected version first appeared at thelancet.com on September 28, 2023BACKGROUND : Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most recent evidentiary and analytical framework from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced location-specific, age-specific, and sex-specific estimates of diabetes prevalence and burden from 1990 to 2021, the proportion of type 1 and type 2 diabetes in 2021, the proportion of the type 2 diabetes burden attributable to selected risk factors, and projections of diabetes prevalence through 2050. METHODS : Estimates of diabetes prevalence and burden were computed in 204 countries and territories, across 25 age groups, for males and females separately and combined; these estimates comprised lost years of healthy life, measured in disability-adjusted life-years (DALYs; defined as the sum of years of life lost [YLLs] and years lived with disability [YLDs]). We used the Cause of Death Ensemble model (CODEm) approach to estimate deaths due to diabetes, incorporating 25 666 location-years of data from vital registration and verbal autopsy reports in separate total (including both type 1 and type 2 diabetes) and type-specific models. Other forms of diabetes, including gestational and monogenic diabetes, were not explicitly modelled. Total and type 1 diabetes prevalence was estimated by use of a Bayesian meta-regression modelling tool, DisMod-MR 2.1, to analyse 1527 location-years of data from the scientific literature, survey microdata, and insurance claims; type 2 diabetes estimates were computed by subtracting type 1 diabetes from total estimates. Mortality and prevalence estimates, along with standard life expectancy and disability weights, were used to calculate YLLs, YLDs, and DALYs. When appropriate, we extrapolated estimates to a hypothetical population with a standardised age structure to allow comparison in populations with different age structures. We used the comparative risk assessment framework to estimate the risk-attributable type 2 diabetes burden for 16 risk factors falling under risk categories including environmental and occupational factors, tobacco use, high alcohol use, high body-mass index (BMI), dietary factors, and low physical activity. Using a regression framework, we forecast type 1 and type 2 diabetes prevalence through 2050 with Socio-demographic Index (SDI) and high BMI as predictors, respectively. FINDINGS : In 2021, there were 529 million (95% uncertainty interval [UI] 500–564) people living with diabetes worldwide, and the global age-standardised total diabetes prevalence was 6·1% (5·8–6·5). At the super-region level, the highest age-standardised rates were observed in north Africa and the Middle East (9·3% [8·7–9·9]) and, at the regional level, in Oceania (12·3% [11·5–13·0]). Nationally, Qatar had the world’s highest age-specific prevalence of diabetes, at 76·1% (73·1–79·5) in individuals aged 75–79 years. Total diabetes prevalence—especially among older adults—primarily reflects type 2 diabetes, which in 2021 accounted for 96·0% (95·1–96·8) of diabetes cases and 95·4% (94·9–95·9) of diabetes DALYs worldwide. In 2021, 52·2% (25·5–71·8) of global type 2 diabetes DALYs were attributable to high BMI. The contribution of high BMI to type 2 diabetes DALYs rose by 24·3% (18·5–30·4) worldwide between 1990 and 2021. By 2050, more than 1·31 billion (1·22–1·39) people are projected to have diabetes, with expected age-standardised total diabetes prevalence rates greater than 10% in two super-regions: 16·8% (16·1–17·6) in north Africa and the Middle East and 11·3% (10·8–11·9) in Latin America and Caribbean. By 2050, 89 (43·6%) of 204 countries and territories will have an age-standardised rate greater than 10%. INTERPRETATION : Diabetes remains a substantial public health issue. Type 2 diabetes, which makes up the bulk of diabetes cases, is largely preventable and, in some cases, potentially reversible if identified and managed early in the disease course. However, all evidence indicates that diabetes prevalence is increasing worldwide, primarily due to a rise in obesity caused by multiple factors. Preventing and controlling type 2 diabetes remains an ongoing challenge. It is essential to better understand disparities in risk factor profiles and diabetes burden across populations, to inform strategies to successfully control diabetes risk factors within the context of multiple and complex drivers.Bill & Melinda Gates Foundation.http://www.thelancet.comam2024School of Health Systems and Public Health (SHSPH)SDG-03:Good heatlh and well-bein

Collapse assessment of concrete buildings : an application to non-ductile reinforced concrete moment frames

Existing reinforced concrete buildings lacking details for ductile response during earthquake shaking represent prevalent construction type in high seismic zones around the world. Seismic rehabilitation of these existing buildings plays an important role in reducing urban seismic risk; however, with the massive inventory of existing concrete buildings and high costs of seismic rehabilitation, it is necessary to start by identifying and retrofitting those buildings which are most vulnerable to collapse. The collapse of most non-ductile concrete buildings will be controlled by the loss of support for gravity loads prior to the development of a side-sway collapse mechanism. “Gravity load collapse” may be precipitated by axial-load failure of columns, punching-shear failure of slab-column connections, or axial-load failure beam-column joints. In this dissertation, system-level collapse criteria are developed and implemented in a structural analysis platform to allow for a more accurate detection of collapse in these existing moment frames. Detailed models for primary components, which may precipitate gravity-load collapse of the concrete moment frame, are first required to achieve this objective and develop the collapse assessment framework. An analytical model based on mechanics is developed to reliably capture the lateral load–deformation response of a broad range of reinforced concrete columns with limited ductility due to degradation of shear resistance, either before or after flexural yielding. The robust collapse performance assessment could be used for many structural applications. In this dissertation, it is used to identify collapse indicators, design and response parameters that are correlated with “elevated” collapse probability. The collapse assessment framework is also used to identify the relative collapse risk of different rehabilitation techniques. Finally, the framework is used to estimate the impact of collapse criteria on the expected financial losses for existing concrete frame buildings in high seismic zones. This dissertation includes important contributions to (1) modeling techniques for components in existing concrete frames through the development of a mechanical model for existing concrete columns, (2) development of system-level collapse criteria, and (3) application of collapse fragilities in defining collapse indicators, improving loss estimation of existing concrete frames, and differentiating the collapse performances of existing and retrofitted concrete frames.Applied Science, Faculty ofCivil Engineering, Department ofGraduat

The Relationship between Personality Aspects, Problem Solving and Psychological Well-being: The Role of Narcissism

This study is mainly aimed at investigating the role of narcissism in predicting personality aspects, problem solving and psychological well-being. To this end, 180 people (102 girls and 78 boys) were selected from among the students at Payame Noor University of Guilan Province in the academic year 2013-2014 using the random cluster sampling method and completed the narcissistic personality inventory (Raskin and Terry, 1988), big five personality questionnaire (Costa & McCrae, 1989), psychological well-being questionnaire (Ryff, 1989), and problem solving styles questionnaire (Cassidy & Long, 1996). The data were analyzed by means of Pearson correlation and regression. Findings suggest that narcissism is capable, as an important psychological constituent, of predicting personality aspects, problem solving styles and psychological well-being in the students. Such findings help explain why people's narcissism is an important variable. Dealing with this constituent is recommended in research areas of personality psychology and social psychology