Higher dialysis adequacy with 3 mEq/lit versus 1 mEq/lit Potassium hemodialysis solution

Routinely hemodialysis (HD) solution with a K+ concentration of 1 mEq/lit is being used in Iranian HD centers. This dialysate K+ concentration may cause dangerous hypokalemia during HD session, and other K+ concentrations of HD solutions are not available. In two previous studies, the effects of different K+ concentrations on dialysis efficacy were studied, which had conflicting results. So we studied the effect of one and three mEq/lit K+ concentrations of HD solutions on dialysis efficacy and serum K+ level at the end and 30 minutes after HD session. 30 chronic stable HD patients contributed in a double blind crossover study. Patients in the first session of two consecutive weeks were hemodialyzed with 1 and 3 mEq/lit K+ dialysis. At 30 seconds after HD, dangerous hypokalemia ([K+]5.5 mEq/lit) was similar with both K+ concentrations. 30 minutes after completion of HD, better HD adequacy was achieved with 3 mEq/lit compared with 1 mEq/lit K+ dialysate concentration measured with Kt/V (0.93±0.3 vs. 0.84±0.34, P<0.05) and urea reduction ratio (0.52±0.12 vs. 0.48±0.17, P<0.05). Therefore using 3 mEq/lit K+ dialysate concentration is safer and causes a higher dialysis efficacy compared with 1 mEq/lit K+ dialysate concentratio

Serum leptin level has a positive correlation with BMI and creatinine clearance in CAPD patients

Objective: In a cross sectional study, 75 patients (42 males and 33 females) on continuous ambulatory peritoneal dialysis (CAPD) were enrolled from October 2007 to February 2008. Serum levels of leptin, albumin, triglyceride, dialysis adequacy (total KTN), renal creatinine clearance (Cr Cl), mid arm circumference and demographic findings were measured in all patients. Results: The mean age of patients was 53+/-14.76. The history of hemodialysis was seen in 23 patients. Mean serum leptin level in women and men were 27+/-23 mu g/l and 16+/-13 mu g/l, respectively. A significant correlation of serum leptin level with body mass index (BMI) (p0.05). Conclusions: To our knowledge, this is probably the first study to report that serum leptin level has a direct positive correlation with renal Cr Cl in CAPD patients. This may explain the increase in mortality in patients with lower serum leptin levels (Tab. 2, Fig. 2, Ref. 25). Full Text in PDF www.elis.sk

Allopourinol effect on reducing proteinuria in diabetic retinopathy

Background: Diabetic nephropathy is the most prevalent cause of end stage renal disease (ESRD). Besides, factors such as angiotensin-II, cytokines, and vascular endothelial growth factor (VEGF), uric acid may play a role as the underlying cause of diabetic nephropathy. Therefore, decreasing serum level of uric acid can be effective in treatment of diabetic nephropathy. Methods: This was a double-blinded, randomized, clinical trial in which 40 patients with type 2 diabetes mellitus (DM) and diabetic nephropathy with proteinuria (at least 500 mg/24h) and serum creatinine (Cr) level 0.05). Serum level of uric acid and 24 hour urine protein were significantly lower in control group, after four months of receiving allopurinol, compared with control group (P < 0.05). Conclusion: Low dose allopurinol (100mg/day) reduces severity of proteinuria after four months of taking, which is probably due to decreasing the serum level of uric acid. So, allopurinol can be administered as an adjuvant, cheap, and low side-effect therapy for patients with diabetic nephropathy

Effect of Allopurinol in Decreasing Proteinuria in Type 2 Diabetic Patients

Introduction. Diabetic nephropathy is the most prevalent cause of end-stage renal disease. Besides factors such as angiotensin II, cytokines, and vascular endothelial growth factor, uric acid may play a role as the underlying cause of diabetic nephropathy. We evaluated allopurinol effects on proteinuria in diabetic patients with nephropathy. Materials and Methods. In a double-blinded randomized controlled trial on 40 patients with type 2 diabetes mellitus and diabetic nephropathy (proteinuria, at least 500 mg/24 h and a serum creatinine level less than 3 mg/dL), allopurinol (100 mg/d) was compared with placebo. Administration of antihypertensive and renoprotective drugs (angiotensin-converting enzyme inhibitors and angiotensin receptor blockers continued for both groups, without changes in dosage. Proteinuria was compared at baseline and 2 and 4 months between the two groups. Results. Each group consisted of 9 men and 11 women. There were no difference between two groups regarding age, body mass index, duration of diabetes mellitus, systolic and diastolic blood pressure, fasting blood glucose, blood urea nitrogen, serum creatinine, serum potassium, and urine volume. Serum levels of uric acid (P = .02) and 24-hour urine protein (P = .049) were significantly lower in the patients on allopurinol, after 4 months of receiving allopurinol, compared with the control group. Conclusions. Low-dose allopurinol can reduce severity of proteinuria after 4 months of drug administration, which is probably due to decreasing the serum level of uric acid. Thus, allopurinol can be administered as an adjuvant cost-effective therapy for patients with diabetic nephropathy

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

Comparison of the effect of delivery type on the quality of life in women attending to health centers of Ilam and Aivan during 2013

زمینه و هدف: در دوره پس از زایمان برخی تغییرات جسمی، روحی و اجتماعی در مادر بوجود می آید که بر کیفیت زندگی مادران و خانواده هایشان تأثیر می گذارد. با توجه به اهمیت کیفیت زندگی و دوره بعد از زایمان و عوامل موثر بر کیفیت زندگی پس از زایمان، از جمله نوع زایمان، این مطالعه به منظور مقایسه کیفیت زندگی زنان با زایمان طبیعی و سزارین در هشت هفته بعد از زایمان انجام شد. روش بررسی: این مطالعه توصیفی - تحلیلی بر روی100 خانم 35-18 ساله مراجعه کننده به مراکز بهداشتی درمانی شهرهای ایلام و ایوان در سال 1392 که معیارهای ورود به مطالعه را داشتند انجام شد. کیفیت زندگی نمونه ها در 2 تا 8 هفته اول بعد از زایمان، با استفاده از ابزار کیفیت زندگی SF-36 ارزیابی و مورد بررسی و مقایسه قرار گرفت. یافته ها: نتایج نشان داد میانگین نمره حیطه جسمانی کیفیت زندگی در گروه زایمان با روش طبیعی 77/17 ± 60/76 و بالاتر از میانگین نمره گروه زایمان با روش سزارین (72/17 ± 10/54) بود. همچنین میانگین نمره حیطه روانی کیفیت زندگی در گروه زایمان با روش طبیعی 04/19 ± 60/67 بود که این میزان بالاتر از میانگین گروه زایمان با روش سزارین (71/15 ± 60/63) می باشد. آزمون تی تفاوت معنی داری را بین دو گروه در حیطه های جسمانی و روانی کیفیت زندگی نشان داد (

The Prevalence of Pain and the Role of Analgesic Drugs in Pain Management in Patients with Trauma in Emergency Department

Background: Pain could potentially affect all aspects of patient admission course and outcome in emergency&nbsp;department (ED) when left undertreated. The alleviation of acute pain remains simply affordable but is usually,&nbsp;and sometimes purposefully, left untreated in patients with trauma. This study challenged the conventional&nbsp;emergency department policies in reducing the intensity of acute pain considering the pharmacological treatments.Methods: In this case-control study, the prevalence and intensity of pain in 200 patients were evaluated on&nbsp;admission (T1) and 24 hours later (T2) based on the valid, standardized 10-point numeric rating scale (NRS 0-10) for pain intensity. A group of patients received analgesic drugs and others did not. Changes in pain&nbsp;patterns regarding different aspects of trauma injuries in these two groups were compared.Results: The pain prevalence was high both on admission and 24 hours later. 51.5% of the study population&nbsp;received analgesics and 77.6% of them reported a decrease in the intensity of their pain. Only half of the&nbsp;patients, who did not receive any medication, reported a decrease in their pain intensity after 24 hours. The&nbsp;most beneficial policy to manage the acute pain was a combination therapy of the injury treatment and a&nbsp;supplementary pharmacological intervention.Conclusions: Pharmacological management of pain in patients with trauma is shown to be significantly&nbsp;beneficial for patients as it eases getting along with the pain, and still seems not to affect the diagnostic aspects&nbsp;of the trauma. Pain management protocols or algorithms could potentially minimize the barriers in current pain&nbsp;management of patients with trauma

Primary Pulmonary Plasmacytoma with Diffuse Alveolar Consolidation: A Case Report

Solitary extramedullary plasmacytomas are plasma cell tumors that tend to develop in mucosa-associated lymphoid tissues including the sinonasal or nasopharyngeal regions. Primary plasmacytoma of the lung is exceedingly rare and often presents as a solitary mass or nodule in mid-lung or hilar areas and diagnosed after resection. Herein, we report a case of primary pulmonary plasmacytoma that presented with diffuse alveolar consolidation and diagnosed by transbronchial lung biopsy

Dysregulation of NF-κB-Associated LncRNAs in Autism Spectrum Disorder

Autism spectrum disorder (ASD) is a long-standing neurodevelopmental condition with prominent effects on social behavior of affected children. This disorder has been linked with neuroinflammatory responses. NF-κB has been shown to affect these responses in the orbitofrontal cortex of patients with ASD, thus being implicated in the pathogenesis of ASD. We measured expression of some NF-κB-associated lncRNAs and mRNAs (DILC, ANRIL, PACER, CHAST, ADINR, DICER1-AS1, HNF1A-AS1, NKILA, ATG5 and CEBPA) in the peripheral blood of ASD kids vs. healthy children. Expression quantities of ADINR, ANRIL, DILC, NKILA and CHAST were meaningfully higher in ASD cases compared with healthy kids (Posterior Beta = 1.402, P value < 0.0001; Posterior Beta = 2.959, P value < 0.0001; Posterior Beta = 0.882, P value = 0.012; Posterior Beta = 1.461, P value < 0.0001; Posterior Beta = 0.541, P value = 0.043, respectively). The Bonferroni corrected P values for these lncRNAs remained significant except for CHAST and DILC. Expression levels of other genes were not considerably different between cases and controls. Expressions of ATG5, DICER-AS1 and DILC were correlated with age of ASD patients (P < 0.0001). Among ASD cases, the most robust correlation has been detected between ADINR and NKILA (r = 0.87, P < 0.0001). Expression of none of genes has been correlated with age of healthy children. Among this group of children, expression levels of ADINR and CHAST were robustly correlated (r = 0.83, P < 0.0001). ANRIL had the greatest AUC value (AUC = 0.857), thus the best diagnostic power among the assessed genes. NKILA ranked the second position in this regard (AUC = 0.757). Thus, NF-κB-associated lncRNAs might partake in the pathogenesis of ASD