Blood pressure of children of rural areas regarding height percentile, Shahrekord, 2000

فشار خون براساس سن، قد و وزن متغیر است و لذا برای تفسیر آن نیاز به استاندارد قابل قبول در جامعه می باشد که این استانداردها نیز براساس نژاد و نوع رژیم غذایی متفاوت است. این مطالعه به منظور تعیین جدول فشار خون 95-90 پرسنتایل براساس منحنی صدک قد کودکان 12-7 سال کودکان روستایی شهرستان شهرکرد انجام شد. قد، فشار خون سیستولیک و دیاستولیک 2000 کودک 12-7 سال روستایی اندازه گیری شد. کودکان به دو گروه جنسی مذکر و مونث تقسیم شدند و هرکدام در 6 گروه سنی (7، 8، 9، 10، 11، 12) قرار گرفتند، سپس میانگین قد و فشار خون کودکان مورد مطالعه استخراج و با استفاده از آزمون آماری X² رابطه فشار خون سیستولیک و دیاستولیک با متغیرهای مورد مطالعه مورد بررسی قرار گرفت. نتایج تحقیق نشان داد که: 1) فشار خون سیستولیک و دیاستولیک با افزایش قد افزایش می یابد، 2) فشار سیستولی و دیاستولی در سنین 7، 8 و 9 در دختران کمتر از پسرها بود، 3) فشار خون سیستولی و دیاستولی در سنین 10، 11 و 12 در دختران بیشتر از پسرها بود، 4) فشار سیستولی و دیاستولی در کودکان مورد مطالعه ما کمتر از گروه استاندارد (Task force) بود. نتایج تحقیق نشان می دهد فشار خون سیستولی و دیاستولی در کودکان جامعه ما کمتر از کودکان غربی است لذا توصیه می شود که استانداردهای فشار خون در کودکان ایرانی نیز مشخص گردد

Fungal peritonitis in Iranian children on continuous ambulatory peritoneal dialysis: a national experience.

INTRODUCTION. Fungal peritonitis (FP), causing catheter obstruction, dialysis failure, and peritoneal dysfunction, is a rare but serious complication of peritoneal dialysis. In this study, the frequency and risk factors of FP are evaluated in children who underwent peritoneal dialysis. MATERIALS AND METHODS. A retrospective multicenter study was performed at the 5 pediatric peritoneal dialysis centers in Iran from 1971 to 2006, and FP episodes among 93 children were reviewed. Risk ratios were calculated for the clinical and demographic variables to determine the risk factors of FP. RESULTS. Ninety-three children aged 39 months on average were included in study. Sixteen out of 155 episodes of peritonitis were fungi infections, all by Candida albicans. The risk of FP was higher in those with relapsing bacterial peritonitis (P = .009). Also, all of the patients had received antibiotics within the 1 month prior to the development of FP. Catheters were removed in all patients after 1 to 7 days of developing FP. Six out of 12 patients had catheter obstruction and peritoneal loss after the treatment and 5 died due to infection. CONCLUSIONS. Fungal peritonitis, accompanied by high morbidity and mortality in children should be reduced by prevention of bacterial peritonitis. Early removal of catheter after recognition of FP should be considered

Fungal peritonitis in Iranian children on continuous ambulatory peritoneal dialysis: a national experience.

INTRODUCTION. Fungal peritonitis (FP), causing catheter obstruction, dialysis failure, and peritoneal dysfunction, is a rare but serious complication of peritoneal dialysis. In this study, the frequency and risk factors of FP are evaluated in children who underwent peritoneal dialysis. MATERIALS AND METHODS. A retrospective multicenter study was performed at the 5 pediatric peritoneal dialysis centers in Iran from 1971 to 2006, and FP episodes among 93 children were reviewed. Risk ratios were calculated for the clinical and demographic variables to determine the risk factors of FP. RESULTS. Ninety-three children aged 39 months on average were included in study. Sixteen out of 155 episodes of peritonitis were fungi infections, all by Candida albicans. The risk of FP was higher in those with relapsing bacterial peritonitis (P = .009). Also, all of the patients had received antibiotics within the 1 month prior to the development of FP. Catheters were removed in all patients after 1 to 7 days of developing FP. Six out of 12 patients had catheter obstruction and peritoneal loss after the treatment and 5 died due to infection. CONCLUSIONS. Fungal peritonitis, accompanied by high morbidity and mortality in children should be reduced by prevention of bacterial peritonitis. Early removal of catheter after recognition of FP should be considered

Endothelial Function in Adolescents with a History of Premature Coronary Artery Disease in One Parent

Background: In young adults, a family history of premature coronary artery disease (CAD), as well as genetic and environmental factors are independent risk factors for coronary artery disease.
 Methods: Endothelial function was studied in 30 children (21 boys and 9 girls with mean age of 14.9 +/- 2.3 years old) of patients with documented CAD (men 45 and women 50 years old). Chidren did not have any history of diabetes mellitus, dyslipidemia, hypertension, and smoking (active/passive). Using vascular ultrasound, we measured resting Basal Brachial artery Diameter (BBD) and Endothelium-Dependent Dilatation (EDD) in response to increased flow and sublingual glyceryltrinitrate (GTN), an Endothelium-Independent Dilation (EID). These parameters were also measured in 30 control subjects with normal parents (18 boys and 12 girls with mean age of 14.2 +/- 2/5years old) and results were compared with each other.
 Results: Adolescents in CAD group had abnormal Endothelial Dependent Dilatation or EDD/BBD (8.5 +/- 3.4% vs 11.8 +/- 4.5% in control subjects; P= 0.003).Endothelial Independent Dilatation (EID/BBD) in the positive fimily history group was significantly more than control subjects (18.5 +/- 6.7% vs 11.9 +/- 5.2%; P <0.001). EDD/EID or the index of endothelial function was significantly lower in the positive family history group (0.92 +/- 0.05 vs 1+/- 0.03; P<0.001). There was no difference in EDD/EID index between those with history of premature CAD in mother (7 cases) and those with history of premature CAD in father (23 cases) (0.92 +/- 0.04 vs 0.91+/- 0.05).
 Conclusion: Normal adolescents without any cardiovascular risk factors but a history of premature coronary artery disease in one parent may have endothelial dysfunction, and there is no difference whether the CAD is in mother or father.
 Keywords: Endothelial dependent dilation, family history, CAD risk factors, premature coronary artery diseas

Deferoxamine protective effect in preventing nephrotoxicity in childreunder treatment with doxorubicin: A randomized clinical trial

Background: Nephrotoxicity secondary to doxorubicin (DOX) may be associated with high morbidity and mortality rates. We aimed to assess the efficacy of Deferoxamine (DFO) in preventing DOX-induced nephrotoxicity in pediatric malignancy. Methods: This Parallel-group randomized clinical trial was done on 62 children aged 2-18 years who had new onset malignancy treated with DOX. They were randomly assigned in three groups; group 1 (no intervention, n=21), group II (DFO 10 times DOX dose, n=20), group III (DFO 50mg/kg, n=21). Patients in the intervention groups received DFO concomitant with DOX 8-hour intravenous infusion in each chemotherapy course. Blood urea nitrogen, serum creatinine, electrolytes, calcium, phosphorus, magnesium and albumin levels, urine microalbumin, urine protein/creatinine ratio, and urine N-acetyl-β-D-glucosaminidase (NAG) as well as findings of kidney ultrasonography were compared between the groups after the last course of chemotherapy. The primary outcome was to compare the radiologic and serologic markers of glomerular and tubular damage between the 3 groups. Results: Sixty patients were analyzed. Patients treated with DFO 10 times the dose of DOX had significantly lower urine NAG level compared to the control group (P=0.032). No significant renal damage was reported in their ultrasonography in the 3 groups. DFO was safely tolerated without any adverse effect. Conclusion: DFO with 10-times the DOX dose may effectively prevent DOX-induced nephrotoxicity at least at the molecular level. Increasing the dose of DFO is not accompanied by better efficacy

Dental Abnormalities in Schimke immuno-osseous dysplasia

Described for the first time in 1971, Schimke immuno-osseous dysplasia (SIOD) is an autosomal-recessive multisystem disorder that is caused by bi-allelic mutations of SMARCAL1, which encodes a DNA annealing helicase. To define better the dental anomalies of SIOD, we reviewed the records from SIOD patients with identified bi-allelic SMARCAL1 mutations, and we found that 66.0% had microdontia, hypodontia, or malformed deciduous and permanent molars. Immunohistochemical analyses showed expression of SMARCAL1 in all developing teeth, raising the possibility that the malformations are cell-autonomous consequences of SMARCAL1 deficiency. We also found that stimulation of cultured skin fibroblasts from SIOD patients with the tooth morphogens WNT3A, BMP4, and TGFβ1 identified altered transcriptional responses, raising the hypothesis that the dental malformations arise in part from altered responses to developmental morphogens. To the best of our knowledge, this is the first systematic study of the dental anomalies associated with SIOD