Serum hyaluronate as a non-invasive marker of hepatic fibrosis and inflammation in HBeAg-negative chronic hepatitis B

Background: HBV infection is a serious global heath problem. It is crucial to monitor this disease more closely with a non-invasive marker in clinical trials. We aimed to evaluate the predictive value of serum hyaluronate for the presence of extensive liver fibrosis and inflammation. Methods: 28 healthy volunteers and 65 patients with HBeAg negative chronic hepatitis B were enrolled. Liver biopsies scored according to Ishak system. Association of serum hyaloronate with liver fibrosis and inflammation were assessed, and cut off points for serum hyaluronate levels were identified by receiver operating characteristics (ROC) curves and their values for prediction of fibrosis and inflammation were assessed. Results: In patients with CHB serum hyaluronate had the most significant correlation and predictive values for the liver fibrosis and inflammation comparing to the other variables. At the cut off point of 126.4 ngm/ml it could discriminate extensive fibrosis from milder ones with sensitivity of 90.9% and specificity of 98.1%. With the same value it could discriminate extensive inflammation from their milder counterparts with sensitivity of 63.6% and specificity of 92.6%. Conclusion: Serum hyaluronate was the best predictor of extensive liver fibrosis and inflammation and it could discriminate subgroups of patients with chronic hepatitis B. It could be used as a non-invasive test to monitor these patients more closely with developing anti viral agents in clinical trials

The Study of Abnormal Liver Ultrasound Findings in Candidate Patients Undergoing Renal Transplantation from Brain Dead Donors

BACKGROUND AND OBJECTIVE: Chronic kidney disease in addition to kidney involvement may cause abnormalities in various systems of the body, in which liver disorders are one of the most commonly encountered disorders. Failure to identify some of these disorders can cause a serious problem in transolant patient. This study was performed to determine the frequency and type of abnormal liver ultrasound findings in renal transplant patients. METHODS: In this cross-sectional study, recorded data of 480 kidney failure patients who had received kidney transplant from brain death donors during the last 6 years in three Mashhad hospitals were investigated. Ultrasonography was considered before the transplant and abnormal liver findings were recorded in a checklist and were assesed. FINDINGS: The mean age was 39.07±12.67 years of which 52.70% were male and 42.30% were female. Liver disorders were observed in 13.12% of patients. The highest prevalence was related to fatty liver grade I (2.5%), grade II (1.46%), gallstone (1.25%) and liver cysts (1.25%). CONCLUSION: The results of the study showed that liver asymptomatic disorders in renal transplant patients have significant prevalence and because some of these disorders require treatment before transplantation, enough attention to screening before transplantation can help to prevent post-transplant complications

Continues renal replacement therapy (CRRT) with disposable hemoperfusion cartridge: A promising option for severe COVID-19

Cytokine release syndrome is prevalent in severe cases of COVID-19. In this syndrome, an uncontrolled response of immune system occurs. Extracorporeal blood purification has been proven to effectively remove the released inflammatory cytokines. Here, we reported a successful case to represent our experience of extracorporeal blood purification in a patient with severe COVID-19. © 2020 The Author

Insight into blood pressure targets for universal coverage of hypertension services in Iran: the 2017 ACC/AHA versus JNC 8 hypertension guidelines

BACKGROUND: We compared the prevalence, awareness, treatment, and control of hypertension in Iran based on two hypertension guidelines; the 2017 ACC/AHA -with an aggressive blood pressure target of 130/80 mmHg- and the commonly used JNC8 guideline cut-off of 140/90 mmHg. We shed light on the implications of the 2017 ACC/AHA for population subgroups and high-risk individuals who were eligible for non-pharmacologic and pharmacologic therapies. METHODS: Data was obtained from the Iran national STEPS 2016 study. Participants included 27,738 adults aged ≥25 years as a representative sample of Iranians. Regression models of survey design were used to examine the determinants of prevalence, awareness, treatment, and control of hypertension. RESULTS: The prevalence of hypertension based on JNC8 was 29.9% (95% CI: 29.2-30.6), which soared to 53.7% (52.9-54.4) based on the 2017 ACC/AHA. The percentage of awareness, treatment, and control were 59.2% (58.0-60.3), 80.2% (78.9-81.4), and 39.1% (37.4-40.7) based on JNC8, which dropped to 37.1% (36.2-38.0), 71.3% (69.9-72.7), and 19.6% (18.3-21.0), respectively, by applying the 2017 ACC/AHA. Based on the new guideline, adults aged 25-34 years had the largest increase in prevalence (from 7.3 to 30.7%). They also had the lowest awareness and treatment rate, contrary to the highest control rate (36.5%) between age groups. Compared with JNC8, based on the 2017 ACC/AHA, 24, 15, 17, and 11% more individuals with dyslipidaemia, high triglycerides, diabetes, and cardiovascular disease events, respectively, fell into the hypertensive category. Yet, based on the 2017 ACC/AHA, 68.2% of individuals falling into the hypertensive category were eligible for receiving pharmacologic therapy (versus 95.7% in JNC8). LDL cholesterol< 130 mg/dL, sufficient physical activity (Metabolic Equivalents≥600/week), and Body Mass Index were found to change blood pressure by - 3.56(- 4.38, - 2.74), - 2.04(- 2.58, - 1.50), and 0.48(0.42, 0.53) mmHg, respectively. CONCLUSIONS: Switching from JNC8 to 2017 ACC/AHA sharply increased the prevalence and drastically decreased the awareness, treatment, and control in Iran. Based on the 2017 ACC/AHA, more young adults and those with chronic comorbidities fell into the hypertensive category; these individuals might benefit from earlier interventions such as lifestyle modifications. The low control rate among individuals receiving treatment warrants a critical review of hypertension services

Is salt intake reduction a universal intervention for both normotensive and hypertensive people: a case from Iran STEPS survey 2016

Purpose: There is a direct association between salt intake and blood pressure (BP), one of the main risk factors for CVDs. However, yet there has been a debate that how strong is this association in people with and without hypertension. This study was conducted to evaluate the magnitude of the association between salt intake and BP in hypertensive and normotensive population among a nationally representative population. Methods: The study was conducted on a nationally representative sample of 18,635 Iranian adults aged 25 years and older who participated in the STEPS survey 2016 and provided urine sample. Salt intake was estimated through spot urine sample and Tanaka equation. Multiple linear regression model in survey data analysis was used to assess the independent effect of salt intake on BP. Results: After adjusting for covariates, there was a significant association between salt intake and SBP in hypertensive (p ' 0.001) and normotensive people (p ' 0.001). In hypertensive people, with 1 g of increase in salt intake, the SBP and DBP increased 0.37 mmHg and 0.07 mmHg, respectively. Whereas in normotensive people, with 1 g of increase in salt intake, the SBP and DBP increased 0.26 mmHg and 0.05 mmHg, respectively. Moreover, there was a significant trend toward an increase of SBP across salt intake quartiles in both hypertensive (p ' 0.001) and normotensive people (p = 0.002), though the slope was steeper in hypertensive than in normotensive people. Conclusions: The present study demonstrated that salt intake significantly increased SBP in both hypertensive and normotensive people, though the magnitude of this increase was greater in hypertensive people as compared with normotensive people

In search of tools for the use of Country-Image (CI) in the brand

Existing country image (CI) literature tends to focus on consumer behaviour. In contrast, this paper approaches CI from the point of view of the firm. In doing so, it seeks to identify the means by which international companies associate a brand with a specific country of origin in order to build brand values. In particular, it looks at the use of CI cues in brand strategies. The paper is based on exploratory research comprising a case study of two contrasting companies from the cosmetics industry, Natura, a domestic company, and the French-owned L’Occitane, both of which draw on images of Brazil to build their brands. Specific elements of CI used in branding are identified, and the extent to which the use of these differs depending on the origin of the owning company is explored. The cases suggest that CI can be exploited in different contexts. Through analysis of the elements used by both companies to build strong brands associated with the Brazilian CI—Natura Cosméticos and L’Occitane au Brésil—six tools are identified that can be combined by firms to deliver brand values, derived from any country, through the use of CI

The country of brand communication in the retail setting: An analysis of Italian products in China

The aim of this paper is to investigate the role of country of brand (COB) communication within the retail environment of emerging markets. Drawing from the literature on store image, we developed a framework to analyse static and dynamic elements of COB communication. By adopting an inductive approach, we analysed COB use in a sample of 20 stores of Italian fashion brands in China using the mystery shopping technique. Given the increasing growth of e-retailing in China, the in-store observation is complemented by an analysis of the use of COB within the brand's local website and e-commerce page. In order to have a multi-layered representation of the phenomenon, in-depth interviews with managers of Italian firms in fashion industry are carried out. Findings confirm that retailing represents a primary communication channel for firms operating in China; however, the results of the participant observation show that COB is a cue information utilised only by a small percentage of the sample, mainly in a textual and iconic way. Managerial implications are discussed on the extent to which COB communication in store should be managed within an effective marketing strategy in line with the country and consumer characteristics in order to enhance the brand image in a growing market like China

Does country of origin affect brand associations? The case of Italian brands in China

none3noFindings related to how country of origin affects consumers’ product evaluations are still not consistent. Previous studies are mainly based on experiments and the results related to consumer judgements come from the elaboration of scores given to semantic scale items. Considering that brand image consists of a network of associations, the aim of this research is to evaluate how country of origin affects this entire network. An experiment was conducted involving 301 Chinese subjects to test the hypothesis that country stereotypes can be transferred to brands.noneFrancesca Checchinato, Marta Disegna, Tiziano VescoviChecchinato, Francesca; Disegna, Marta; Vescovi, Tizian

The Role of Virtual Integration, Commitment, and Knowledge-Sharing in Improving International Supplier Responsiveness

Globalization has triggered significant structural strategy shifts of multinational enterprises (MNEs). With increasing global competition, MNEs have disintegrated their value-adding activities with their suppliers or subcontractors around the world (Buckley and Ghauri, 2004; Sturgeon, 2002). As a function of this mega-trend, the issue of how MNEs can effectively coordinate and control their global supply chain relationships with local suppliers becomes a critical task for MNE efficiency and competiveness