3 research outputs found
An estimation of steroid responsiveness of idiopathic nephritic syndrome in Iranian children
Objective: Idiopathic Nephrotic syndrome (INS) is the most common form
of nephrotic syndrome (NS) in children with the potential of
progression to end stage renal disease (ESRD). INS is
steroid-responsive in most children, but not all patients respond to it
The aim of this study was to determine the rate of steroid
responsiveness in children with INS that referred to Children′s
Medical Center since 1995 to 2007. Methods: In as a cross sectional
study, the medical records of all children with INS aged 1 to 15 years
who were referred to our referral hospital was reviewed. All patients
with onset of disease less than 1 year of age, spontaneous remission,
secondary forms of NS associated with systemic diseases, and follow up
duration of less than 12 months were excluded from the study. Patients
were categorized into 6 groups: Group 1 needed biopsy prior to any
treatment, group 2 non-relapsing NS, group 3 infrequently relapsing NS,
Group 4 frequently relapsing NS, group 5 steroid dependent NS and group
6 steroid resistant NS. Findings: A total of 238 patients were enrolled
in the study. Kidney biopsy was performed in 79 cases. Minimal change
lesion (MCL) was the most common (36.7%) pathological diagnosis.
Steroid responsiveness was found in 81.5% of all cases including: 96%
of MCL (consisting of biopsy proven cases and presumed ones), 32% of
focal and segmental glomerulosclerosis, 73% of diffuse mesangial
proliferation and 58% of membranoproliferative glomerulonephritis
patients. During minimal follow up period of 12 months, there were 194
patients in remission, 32 patients with active NS, and 12 patients in
ESRD. Conclusion: Our study results showed that 81.5% of all patients,
96.2% of MCL and 32% of FSGS patients initially responded to steroid
therapy
The Effect of Long-term Steroid Therapy on Linear Growth of Nephrotic Children
Objective: Steroids are still the mainstay of management of nephrotic
syndrome (NS). It was shown that steroids could impair growth and
development of children. However, other clinical studies have shown
conflicting results. Methods: Hospital records of 147 children with
diagnosis of NS who were followed during 1988-2008 are reviewed
relating to height measurements. All patients were treated with
prednisolone and had been followed for at least five years. Height
measures were transformed into standard deviation score (SDS).
Information on dose and duration of prednisolone therapy, histological
findings of biopsy as well as concomitant use of steroid-sparing agents
(SSA) were also analyzed. Findings: Mean age at onset of NS was 5.94
years and at last follow-up visit 15.08 years. All patients had normal
renal function during entire duration of the study. Analysis of the
whole population did not show any significant alterations in the height
SDS (HtSDS) between the first and the last follow-up visit (P=0.5;
-0.76±2.0 vs. -0.89±2.05 respectively). The patients were
divided into two subgroups. Subgroup A, which achieved growth
improvement, was composed of 62 children (initial HtSDS -1.63; final
HtSDS -0.08; P<0.001) and subgroup B, that showed growth
retardation, included 85 children (initial HtSDS -0.13; final HtSDS
-1.59; P<0.001). Conclusion: No statistically significant
retardation of linear growth was observed in the study population as a
group following treatment with prednisolone according to the guidelines
of ISKDC. Although about 62 subjects had growth retardation, children
treated with prednisolone were not different from those who had
increased growth
Socialization During the COVID-19 Pandemic: The Role of Social and Scientific Networks During Social Distancing
In the COVID-19 era, while we are encouraged to be physically far away from each other, social and scientific networking is needed more than ever. The dire consequences of social distancing can be diminished by social networking. Social media, a quintessential component of social networking, facilitates the dissemination of reliable information and fighting against misinformation by health authorities. Distance learning, telemedicine, and telehealth are among the most prominent applications of networking during this pandemic. Additionally, the COVID-19 pandemic highlights the importance of collaborative scientific efforts. In this chapter, we summarize the advantages of harnessing both social and scientific networking in minimizing the harms of this pandemic. We also discuss the extra collaborative measures we can take in our fight against COVID-19, particularly in the scientific field