bluuebunny/crossref_metadata_2025 huggingface dataset:
A computer model for professional competence assessment according to ISO 15189
Authors: Bellini Claudia , Cinci Francesca , Scapellato Carlo , Guerranti Roberto
Published: February 2020

Background

As defined by ISO 15189 competence is the “demonstrated ability to apply knowledge and skills” thus, its assessment is fundamental for ensuring the quality of the total testing process in order to reduce the risk for the patient. We have developed a functional software for the measurement of professional competences in order to standardize the procedure and to collect all the data in a single platform, avoiding redundancy and dispersion.

Methods

Our model objectively assesses the skills, as they become measurable and comparable with appropriate standards and involves both managers and operators, to increase their active engagement. The assessment concerns everyone, but the standards to be met (numerical values) can vary according to the responsibilities. Several subjective and objective criteria are evaluated: each parameter can contribute in a variable proportion to the total skills measured according to the needs of the organization.

Results

The data are automatically analyzed and can be easily monitored in real time in the form of indicators, thanks to dashboards. The comparison between the skills required and those measured allows highlighting the gap useful for planning personalized training paths.

Conclusions

Our tool is reliable and highly adaptable to laboratories about competences to track criteria, standards and monitored indicators. The computerized management is a strategic action as it fulfills the requirements of registration, traceability, communication, data analysis and indicators development, which are the tenets of continuous improvement, and allows planning to be made on the basis of the actual training needs.
Non-ionic surfactant loaded on gel capsules to protect downhole tubes from produced water in acidizing oil wells
Authors: Farag Ahmed A. , Badr Emad A.
Published: February 2020

Gel capsules of calcium alginate as a matrix stuffed with a non-ionic surfactant, namely 2-(2-(3,4-bis(2-methoxyethoxy)tetrahydrofuran-2-yl)-2-(2-methoxyethoxy)ethoxy)ethyl stearate, Tween-60, as an inhibitor was prepared by a piercing-solidifying method for corrosion protection of carbon steel tubes from produced water in acidizing oil wells. The Fourier transform infrared and thermal gravimetric analysis techniques were used to study the properties of the capsules. The release of the inhibitor from the solid capsules to the corrosive acidizing produced water was studied gradually using ultraviolet-visible spectroscopy. A heavy additive was used to promote the sinking of the capsules in the oil well downhole tubes. The inhibitive effect of the released inhibitor on carbon steel in the corrosive produced water in acidizing oil wells was investigated using weight loss measurement, potentiodynamic polarization, electrochemical impedance spectroscopy, and morphologically by scanning electron microscopy. It was found that the inhibition efficiency increases with the increase of inhibitor release. The increase in temperature leads to partial desorption of inhibitor molecules at the metal surface, which causes increase in the corrosion rate. The positive sign of the activation enthalpy (ΔHa) reflects the endothermic nature of the carbon steel dissolution process.
Unique Solution for Multi-point Fractional Integro-Differential Equations
Authors: Zhai Chengbo , Wei Lifang
Published: February 2020

We study a fractional integro-differential equation subject to multi-point boundary conditions:D0+αu(t)+f(t,u(t),Tu(t),Su(t))=b, t∈(0,1),u(0)=u′(0)=⋯=u(n−2)(0)=0,D0+pu(t)|t=1=∑i=1maiD0+qu(t)|t=ξi,$$\left\{\begin{array}{l} D^\alpha_{0^+} u(t)+f(t,u(t),Tu(t),Su(t))=b,\ t\in(0,1),\\u(0)=u^\prime(0)=\cdots=u^{(n-2)}(0)=0,\\ D^p_{0^+}u(t)|_{t=1}=\sum\limits_{i=1}^m a_iD^q_{0^+}u(t)|_{t=\xi_i},\end{array}\right.$$

whereα∈(n−1,n], n∈N, n≥3, ai≥0, 0<ξ1<⋯<ξm≤1, p∈[1,n−2], q∈[0,p],b>0$\alpha\in (n-1,n],\ n\in \textbf{N},\ n\geq 3,\ a_i\geq 0,\ 0<\xi_1<\cdots<\xi_m\leq 1,\ p\in [1,n-2],\ q\in[0,p],b>0$. By utilizing a new fixed point theorem of increasingψ−(h,r)−$\psi-(h,r)-$concave operators defined on special sets in ordered spaces, we demonstrate existence and uniqueness of solutions for this problem. Besides, it is shown that an iterative sequence can be constructed to approximate the unique solution. Finally, the main result is illustrated with the aid of an example.
Conferralism and Intersectionality: A Response to Ásta’s Categories We Live By
Authors: Jenkins Katharine
Published: February 2020

The conferralist account of social properties that Ásta develops and defends in Categories We Live By is persuasive in many ways. Conferralism could however do better, by its own lights, at handling the phenomenon of intersectionality. This paper first suggests a friendly amendment to the schema for conferrals that Asta offers. This helps to explain the difficulty concerning intersectionality. Finally, the paper suggests a way of developing the conferralist account that would resolve this difficulty.
Categories We Do Not Know We Live By
Authors: Burman Åsa
Published: February 2020

I argue that a central claim of Ásta’s conferralist framework – that it can account for all social properties of individuals – is false, by drawing attention to (opaque) class. I then discuss an implication of this objection; conferralism does not meet its own conditions of adequacy, such as providing a theory that helps to understand oppression. My diagnosis is that this objection points to a methodological problem: Ásta and other social ontologists have been fed on a “one-sided diet” of types of examples, resulting in a limited view of the paradigmatic social phenomena, thus making conferralism too narrow to fulfill its intended role.
The di(thiourea)gold(I) complex [Au{S=C(NH2)2}2][SO3Me] as a precursor for the convenient preparation of gold nanoparticles
Authors: Kossmann Alexander , Ehnert Rayko , Preuß Andrea , Rüffer Natalia , Korb Marcus , Schulze Steffen , Tegenkamp Christoph , Köster Frank , Lang Heinrich
Published: February 2020

The synthesis of [Au{S=C(NH2)2}2][SO3Me] (1) (a) by the anodic oxidation of gold metal in an anolyte of thiourea and methansulfonic acid and (b) by the reaction of Au(OH)3 with an aqueous solution of methanesulfonic acid in the presence of thiourea is reported. The structure of 1 in the solid state has been determined by single-crystal X-ray diffraction showing a linear S–Au–S unit with the thiourea ligands in a leaflet structure folded by 113.2(3)°. The cation of complex 1 is a dimer, based on short S · · · C interactions between two adjacent mononuclear cations. The thermal decomposition behavior of 1 was studied by TG and TG-MS confirming that it decomposes under inert gas or oxygen atmosphere in four steps in the temperature range of 200–650°C. Initial decomposition starts with the release and fragmentation of one of the thiourea ligands, followed by the anion degradation. Powder X-ray diffraction studies specified the formation of gold metal. Based on this observation, complex 1 was used as precursor for the formation of gold nanoparticles (Au NPs) in 1-hexadecylamine (c = 4.0 mol L−1) at T = 330°C without any addition of reducing agents. TEM, electron diffraction, and UV/Vis spectroscopy studies were carried out. Au NPs of size 15 ± 4 nm were formed, showing the characteristic surface plasmon resonance at 528 nm.
The effect of interferon-β therapy on brain-derived neurotrophic factor serum concentration in relapsing— remitting multiple sclerosis: a randomized clinical trial
Authors: Majdinasab Nastaran , Bahadoram Mohammad , Mansouri Syed Mohammad Taghi , Tarahomi Shahram , Javanmardi Fatemeh , Haybar Habib
Published: February 2020

Introduction: Beta interferon (IFN-β) is known as the first-line therapy in relapsing-remitting multiple sclerosis (RRMS). Recent studies have shown different effects of IFN-β on brain-derived neurotrophic factor (BDNF) serum levels. Given the known role of BDNF in the restoration and conservation of the nervous system, this study was designed to investigate the possible effect of this drug through stimulating BDNF production. Objectives: Impressible treatments for progressive multiple sclerosis (MS) are still being sought. Individual response to existing treatments for MS varies significantly among patients while the risk of serious adverse events remains an issue, especially for the novel drugs. Patients and Methods: In this clinical trial, 96 patients newly diagnosed with RRMS were studied within three months, in 3 groups of 32 subjects. Each group received one of the foregoing drugs (Avonex, Rebif and Betaferon). BDNF levels were compared between different groups at the end. Results: BDNF serum concentration in all groups was significantly different (P<0.001) compared to baseline after 3 months. And comparison between groups showed a significant difference between the groups receiving Betaferon (IFN-β1b) (P=0.001) and Rebif (P=0.002) compared to the other groups. Avonex compared with either control or Betaferon (IFN-β1b) and Rebif groups showed no significant difference. Also the correlation between the mean changes in expanded disability status scale (EDSS) and BDNF was not observed (r = -0.189, P=0.065). Conclusions: Significant difference in BDNF levels were observed between groups.
Lung cancer risk and the inhibitors of angiotensinconverting enzyme: A mini-review of recent evidence
Authors: Asgharpour Masoumeh , Ebrahimi Kalan Mohammad , Mirhashemi Seyed Hadi , Alirezaei Amirhesam
Published: February 2020

Angiotensin-converting enzyme inhibitors (ACEIs) are among the most widely prescribed antihypertensive medications. They are indicated in the management of multiple chronic conditions including hypertension, diabetes mellitus and heart failure. ACEIs prevent angiotensin II (Ang II) production and bradykinin catabolism leading to vasodilation and reduction of arterial blood pressure. Recently, the role of the reninangiotensin system (RAS) inhibitors has become the subject of scrutiny in the treatment of cancer metastasis. The administration of ACEIs, however, has been described to be accompanying with carcinogenic effects.
Administration of vitamin D to ameliorate dyspnea of chronic obstructive pulmonary disease patients: a randomized controlled trial
Authors: Ghodrati Samad , Ezzatpanah Arian , Asadi-Khiavi Masoud , Alian Samakkah Shohreh , Esmaeilzadeh Abdolreza , Pezeshgi Aiyoub
Published: February 2020

Introduction: As one of the most common causes of human morbidity and mortality, chronic obstructive pulmonary disease (COPD) affects millions around the world. Some evidences have already considered about association between serum levels of vitamin D and COPD. Objectives: This study was aimed to evaluate the effects of vitamin D supplementation on COPD improvement. Patients and Methods: This study was designed as a randomized controlled trial. Forty COPD patients with vitamin D deficiency were enrolled into two groups; cases group who administered vitamin D and control group who received placebo. The severity of dyspnea and spirometric indices were analyzed in both groups. Values were presented as mean and standard deviation (SD) and differences were considered significant at the level of P<0.05. Results: Spirometric indices did not show significant differences before and after vitamin D administration (P>0.05). Dyspnea severity was significantly improved after receiving vitamin D supplementation in comparison with placebo consumption (P=0.03). Conclusion: Spirometric indices were not affected during vitamin D supplementation therapy but it showed a significantly positive effect on the curing of dyspnea. Therefore, adjuvant therapy of COPD using vitamin D supplementation is recommended to better handling of dyspnea in COPD cases.
Predictive value of platelet indices in children with idiopathic nephrotic syndrome
Authors: Nickavar Azar , Sadr  Moharerpour Sahar , Abiry Ehsan
Published: February 2020

Introduction: Different biomarkers have been investigated for prognosis of patients with nephrotic syndrome. Qualitative and quantitative changes have been reported in platelets in these patients. Objectives: The aim of this study was to identify platelet abnormalities and their prognostic value of steroid response in children with idiopathic nephrotic syndrome. Patients and Methods: Platelet counts and indices (mean platelet volume [MPV], platelet distribution width [PDW] and platelet larger cell ratio [PLCR]) were evaluated and compared in 122 children with active nephrotic syndrome (64%; steroid resistant and 36%; steroid sensitive). Results: Mean age at diagnosis was 55 months (6 to169 months), and males outnumbered females (1.7/1). Steroid resistant patients had significantly higher platelet counts and lower PLCR, compared to steroid sensitive group. Regarding area under the ROC curve, low MPV, high PDW and low PLCR showed relatively acceptable correlation with steroid resistance. Conclusion: Increased platelet counts in addition to low PLCR are the suggestive indicators of steroid resistance in children with idiopathic nephrotic syndrome.
Safety and efficacy of high-dose versus low-dose aspirin in individuals with ST elevation myocardial infarction undergoing primary percutaneous coronary intervention: A randomized clinical trial
Authors: Emami Sigaroudi Abdolhossien , Salari Arsalan , Poursadeghi Mohadeseh , Moaddab Fatemeh , Mirrazeghi Seyedeh Fatemeh , Mirbolouk Fardin
Published: February 2020

Introduction: Aspirin is the most frequently used antiplatelet therapy after percutaneous coronary intervention (PCI). Yet, the optimal daily dose of aspirin is unanswered. Objectives: We aimed to compare the effect of high-dose versus low-dose aspirin in a randomized trial of patients with ST-segment elevation myocardial infarction (STEMI) undergoing PCI. Patients and Methods: In a double-blind randomized trial, 175 patients with STEMI were randomly assigned to high-dose or low-dose aspirin. The primary efficacy outcome was major adverse cardiovascular events (MACE) as a composite endpoint of death, myocardial infarction, stroke and revascularization procedures. The primary safety endpoint was major bleeding. Results: Totally 90 and 85 patients were assigned to high-dose and low-dose aspirin, respectively. The incidence rate of MACE was 13.1 and 10.1 per 100 person year in high-dose and low dose aspirin, respectively. There was no significant difference between high-dose and low-dose aspirin in terms of efficacy (Adjusted hazard ratio: 0.85, 95% CI=0.29-2.45) and safety outcome (Adjusted hazard ratio: 1.65, 95% CI=0.41-6.69). Conclusion: Efficacy and safety outcomes were not significantly different between high-dose and low-dose aspirin.
Continuation or termination of metformin in diabetic patients exposed to iodinated contrast medium?
Authors: Dayani Mohamad Ali
Published: February 2020

Lactic acidosis (LA) secondary to metformin administration is a rare incident with a very highmortality rate (≥50%). Hypoxia has been suggested to contribute to metformin-associatedlactic acidosis (MALA) in 90% of patients developing this condition. In susceptible patientssuch as those with renal insufficiency, the level of plasma metformin is increased particularlyafter exposure to iodinated contrast media (ICM). One major concern in patients with renalinsufficiency is to adjust the metformin dose based on the renal functional capacity prior to ICMexamination. In this review, we assessed metformin tolerable threshold in diabetic patients withrenal failure. We also reviewed metformin withdrawal criteria in patients with chronic kidneydisease (CKD) exposed to intravenous ICM during angiography. Our results indicated that inpatients with insufficient renal function (i.e. 30< estimated glomerular filtration rate(eGFR) <60and 30<eGFR<45 mL/min/1.73 m2), or those with acceptable renal function (eGFR ≥60 mL/min/1.73 m2) and concomitant comorbidities, the decision to withhold or reinitiate metforminshould be based on patient’s medical condition.
Ozone therapy in chronic diseases; a narrative review of the literature
Authors: Dayani Mohamad Ali , Hasanpour Dehkordi Ali , Miraghajani Maryam
Published: February 2020

Nitric oxide (NO) has various physiological and biochemical effects. In many biological systems of the body, NO acts as a messenger molecule via cyclic guanosine monophosphate (cGMP), which affects the body cells. NO is synthesized in the body from the L-arginine amino acid by the NO synthases enzyme. This enzyme consists of three major isoforms including neurotransmitter, endothelial and inductive types. According to the results of numerous studies, the administration of ozone as a complementary therapy of the diseases is a less complicated and cost-effective way. Over the past forty years, the results of ozone therapy have been satisfactory and without any problems. Ozone therapy affects various diseases. For example, in treatment for vascular diseases and some degenerative diseases, it has an ameliorative impact. Regarding kidney disease, still many experimental or clinical studies are necessary to find its improvement/anti-oxidative effect.
APOL1 renal risk alleles in patients on chronic hemodialysis in Northwest of Iran
Authors: Zununi Vahed Sepideh , Rikhtegar Ehsan , Ebrahimzadeh Attari Vahideh , Haghi Mehdi , Tolouian Ramin , Mohajel Shoja Mohammadali , Ardalan Mohammadreza
Published: February 2020

Introduction: Apolipoprotein L1 (APOL1) gene’s risk variants located on chromosome 22 are newly discovered factors for the development of chronic renal failure among African-American. These risk alleles were developed on the African continent as an evolutionary defense against sleep sickness due to Trypanosoma brucei rhodesiense and then spread with human migrations. Objectives: In the present study, we sought to examine these risk variants in a group of hemodialysis patients of Northwest of Iran. Patients and Methods: Two hundred patients receiving hemodialysis in different centers of the city (Tabriz in Northwest of Iran) were allocated randomly from a total number of 825 patients. The assessment of APOL1 polymorphisms (rs73885319, rs60910145, and rs71785313) was conducted using polymerase chain reaction–restriction fragment length polymorphism (PCR-RFLP) method. Patients’ demographic data, history, and their biochemical parameters were recorded based on their last measurement. Results: No proposed renal risk variants of APOL1 gene in our hemodialysis population were found. All the participants had a wild genotype. Conclusion: The results of our study match with reports from Europe and Asia. In the paleoanthropological point of view, our results do not support African human migration hypothesis.
The effect of artichoke leaf extract supplementation on lipid profile of chronic kidney disease patients; a double-blind, randomized clinical trial
Authors: Gatmiri Seyed Mansour , Khadem Ebrahim , Fakhrian Toktam , Kamalinejad Mohammad , Hosseini Hamed , Ghorat Fereshteh , Alamdari Azam , Naderi Neda
Published: February 2020

Introduction: Hyperlipidemia is considered a prominent risk factor for coronary heart disease. Coronary heart disease is the most common cause of mortality and morbidity in chronic kidney disease (CKD) patients. Objectives: The aim of this study was to evaluate the effects of artichoke leaf extract (ALE) supplementation on the lipid profile of CKD patients. Patients and Methods: A randomized, double-blind, placebo-controlled clinical trial was conducted in 38 CKD subjects (GFR<60 and >15 mL/min/1.73 m2 ) with hypercholesterolemia (total cholesterol ≥ 200 mg/dL or low-density lipoprotein cholesterol [LDL-C] ≥ 110 mg/dL). The intervention group received an artichoke capsule (320 mg) and an indistinguishable placebo was given to the control group twice daily for 6 weeks. Lipid profile and appetite were assessed at week 8 and the results were compared with the baseline data. Results: ALE supplementation was correlated with a statistically significant decrease in mean total cholesterol (P=0.028) and LDL-C (P=0.005) compared to the control group. The two groups did not show a significant difference in high-density lipoprotein-cholesterol (P=0.071) and triglyceride levels (P=0.22). There was a statistically significant difference in appetite between the two groups (P=0.016). Conclusion: This randomized controlled trial demonstrated that consumption of ALE supplement may improve appetite and lipid profile in CKD patients.
Combined effect of cadmium and noise on rat’s kidney
Authors: Golbaghi Ameneh , Fouladi Dehagi Behzad , Ahmadizadeh Massumeh
Published: February 2020

Introduction: Recently, the consequence of chemical industries and noise on human health is the update subject for researchers. There are many reports published about nephrotoxicity of noise and cadmium alone. Objectives: The main aim of this study was to detect the combined consequence of noise and cadmium on renal function. Materials and Methods: Forty adult male rats were put into eight groups in random order (n=5). Groups 1 control, group 2 exposed to 90 dB (decibels) noise, groups 3- 5 received (intraperitoneal; ip) cadmium chloride (CdCl2) at doses of 1,2,3 mg/kg and group 6-8 pretreated with CdCl2 at doses of 1, 2, and 3 mg/kg 30 minutes before exposing to 90 dB noise. The exercise was repeated for seven consecutive days. Animals were killed 24 hours afterwards. Blood urea nitrogen (BUN) and creatinine (Cr) levels were analyzed. Kidney tissues were excised for measuring malondialdehyde (MDA) and glutathione (GSH) concentrations. Results: There was significant rise on the levels of BUN, Cr and MDA. Additionally, a decrease on the level of GSH in rats that were exposed to noise or cadmium alone or combined to noise and cadmium was detected. Significant elevation of BUN, Cr, MDA and depletion of GSH were also noted in cadmium-treated rats compared to those in the animals co-exposed to cadmium and noise. Conclusion: This study shows that exposed rats to cadmium and/or noise caused renal function impairment. Production of oxidative stress is responsible for cadmium or noise induced nephrotoxicity. However, co-exposure of cadmium and noise reduced nephrotoxicity of cadmium. The possible explanation for noises suppressing cadmium nephrotoxicity is that noise may enhance excretion and/or induced redistribution and depleted accumulation of cadmium in the kidney.
In vitro effect of hydroalcoholic extract of Peganum harmala on human ureteric contractions
Authors: Shirani Majid , Lorigooini Zahra , Pouriamofrad Arsham , Keivani Hafshejani Zahra
Published: February 2020

Introduction: Ureteral obstruction by stones is one of the most common urological problems. Objectives: This study aimed to investigate the in vitro effects of hydroalcoholic extract of Peganum harmala L. on the contraction of the human ureter. Materials and Methods: In this study, 28 samples of human ureter tissue were studied. Six tissue samples were examined for the evaluation of P. harmala extract at concentrations of 1, 2, and 4 mg/mL. Moreover, five tissue samples were examined for checking NaCl solution since, six pieces of tissue for the examination of prazosin 10-8M solution. Results: There was a significant difference between the second contraction of P. harmala group with concentration of 4 mg/mL and NaCl group (P<0.001). Additionally, a significant difference between the prazosin and P. harmala groups with a concentration of 4 mg/mL (P=0.048) was observed. There is a marginal difference between the secondary contractions in two groups. A significant decrease in secondary contraction (15 minutes after adding the solution) was observed between the prazosin group and the P. harmala group at a concentration of 1 mg/mL (P<0.001). Moreover, the secondary contraction of the prazosin group showed a significant decrease compared with the NaCl group (P<0.001). Conclusion: Administration of P. harmala extract can be useful in reducing urinary human ureteric contractions while the best effect was achieved at 4 mg/mL of P. harmala extract.
The association between fever and pyuria in children older than one month
Authors: Mohajeri Saeed , Hemmati Pouria , Sedehi Morteza
Published: February 2020

Introduction: Some assumptions have been made on the probable association between fever and pyuria. Objectives: The present study aimed to investigate the association between fever and pyuria. Patients and Methods: In this case-control study, 90 febrile and 90 non-febrile children aged more than one month who were admitted to the pediatric ward were included. Urine specimens of children less than 2 years of age were collected by urine bag. Midstream urine samples were collected and immediately sent to the laboratory for complete urinalysis and urine culture. Results: Overall, 6.7% in febrile children and 2.2% in control group had pyuria however there was no significant association between fever and pyuria (P>0.05). Additionally, no association between the presence of pyuria and type of disease was detected (P>0.40). Conclusion: The present study could not reveal any association between fever and pyuria in children older than one month.
An analytical study of the factors affecting the health promoting lifestyle; comparison of type II diabetic patients with healthy people
Authors: Pourjam Reyhaneh , Estebsari Fatemeh , Rahimi Khalifeh Kandi Zahra , Estebsri Kimia , Mostafaei Davoud
Published: February 2020

Introduction: The most important risk factors for type II diabetic patients are poor nutrition, low physical activity, smoking and obesity indicating an inappropriate lifestyle. Objectives: This study aimed to investigate the factors affecting the health promoting lifestyle in type II diabetic patients compared with healthy people. Patients and Methods: The study was descriptive-analytic with two case-control groups carried out on 150 type II diabetic patients and 150 healthy people. Data were collected using demographic characteristics questionnaire and health promoting lifestyle profile II (HPLII). Results: There was a significant difference between the lifestyle of type II diabetic patients and healthy people (P<0.001). Additionally, there were significant differences regarding lifestyle dimensions between physical activity, nutrition and stress management in type II diabetic patients compared with healthy people (P<0.001). There was no significant difference between the two groups in the dimensions of spiritual growth (P=0.074), communication with others (P=0.363) and health responsibility (P=0.582). Conclusion: This study showed the effective role of lifestyle components in the development of type II diabetes. It is recommended to prevent or manage type II diabetes, through emphasizing on maintaining lifestyle and its dimensions.
Bilateral Wilms tumor with neonatal onset and the importance of prenatal diagnosis
Authors: De Bernardo Giuseppe , Lucariello Angela , Saggese Antonio , Giordano Maurizio , Sordino Desiree , Buonomo Carmela , Gisone Stefano , De Luca Antonio , Guerra Germano , Perna Angelica
Published: February 2020

Wilms tumor (WT) occurs in 1:10.000 live births and affects mainly the unilateral kidney. The National Wilms Tumor Study Group registered 6832 patients with WT from 1969 to January 1993, out of whom only 11 patients (0.16%) were newborns. Since 1969, 14 cases of prenatal diagnosis of WT have been reported in literature, two of which were bilateral WT. Currently, the patients’ survival rate is greater than 90%, owing to a combination of surgery, chemotherapy, and radiotherapy for high-risk patients. We report a case of bilateral WT, undiagnosed during the prenatal period due to the incomplete evaluation of the abdomen with ultrasonography. The newborn was vaginally delivered at 40 weeks’ gestational age with a good perinatal adaptation. Suddenly, during the night the newborn showed respiratory distress, bradycardia and then respiratory arrest. For this reason, he was ventilated, intubated and subjected to conventional mechanical ventilation. Despite the normal cardiac ultrasonography, the health care providers suspected a cyanotic congenital heart disease with duct dependency. After a gradual resumption of the oximetry and blood pressure, the infant was transported by the neonatal emergency transport system to the Cardiac Pediatric Surgery Department of a level III hospital. There, the clinical condition became extremely serious and the infant died of asystole. During autopsy, two large tumoral masses were found in both kidneys, also the characterization of the tumors was done through histological exam, which confirmed the diagnosis of WT. A prenatal diagnosis of WT is very important because the families can take advantage of prenatal counseling to understand the risks of continuing the pregnancy and to evaluate the need for abortion, while health care providers can prepare to face a difficult delivery. The review of the literature suggests that prenatal diagnosis of bilateral WT is possible. During prenatal age, the complete assessment of the abdomen with ultrasonography and Eco-Color-Doppler can reveal kidney anomalies and raise suspicion of diseases with urinary malformations.
Surveying the relationship between Gly1057Asp polymorphism of IRS-2 gene and susceptibility to type 2 diabetes; a systematic review and meta-analysis study
Authors: Kiani Faezeh , Sayehmiri Fatemeh , Hasanpour Dehkordi Ali , Motedayen Morteza
Published: February 2020

Type 2 diabetes mellitus (T2DM) is a multi-factorial disease in which influenced by several genetic and environmental factors. Insulin receptor substrate 2 (IRS 2) is the main mediator of insulin in the liver which controls insulin sensitivity. Gly1057Asp polymorphism is one of the candidates to increase risk of T2DM. The present study is an attempt to study the relationship of Gly1057Asp polymorphism of IRS-2 and T2DM by a meta-analysis. A systemic search was conducted in English and Persian databases such as Scopus, PubMed, Google Scholar, SID, and other academic databases for studies that have investigated the relationship of Gly1057Asp polymorphism of IRS-2 and T2DM. This association was determined using odds ratios (ORs) with a confidence interval of 95% (CIs). Heterogeneity of the studies was examined by I2 index. Funnel plots and Egger tests were used to determine bias or publication bias. The collected data was analyzed in STATA through meta-analysis. Nine articles were selected as eligible for further analysis, which represented 3,196 patients with T2DM and 3409 controls subjects without T2DM. The present meta-analysis showed a significant relationship between GA genotype of Gly1057Asp polymorphism and T2DM (OR=0.88; 95% confidence interval, 0.79-0.98), whereas no significant relationship between GG and AA genotype with T2DM was seen; OR for GG and AA genotypes were 1.10 (95% CI, 0.99 -1.22) and 1.13 (95% CI, 0.95- 1.33), respectively. The results of our study show that genotype GA of Gly1057Asp polymorphism of IRS-2 gene plays a protective role and may decrease the risk of T2DM, whereas GG and AA genotypes are considered as a risk factor and related to development of T2DM to some extents.
Serum interleukin-18 in children with steroid sensitive nephrotic syndrome
Authors: Sadr Moharrerpour Sahar , Nickavar Azar , Sadeghi Bojd Simin , Makhtomi Sara , Ghorbani Hossein
Published: February 2020

Introduction: Idiopathic nephrotic syndrome has been considered a cell-mediated immunity disorder with T cell dysfunction. Objectives: The purpose of this study was to investigate immunologic dysfunction in children with steroid-sensitive nephrotic syndrome (SSNS) by evaluating serum interleukin-18 (IL-18). Patients and Methods: A total of 30 children with SSNS (n=20 males, n=10 females), aged 1–11 years were enrolled in this study. All of them were treated with steroids at the time of study. Serum IL-18 was compared during both active and remission phases of nephrotic syndrome. In addition, correlation between serum IL-18 with urine protein and serum biochemical variables was evaluated. Results: Mean serum IL-18 was higher in the active phase, and decreased significantly poststeroid treatment (4.87±1.43 ng/L versus 2.39± 0.94 ng/L; P=0.01). It had no correlation with other variables. Conclusion: According to increased serum IL-18 level, dysregulation of type-1 and type-2 mediated immune reactions is suggested in children with SSNS.
Non-neoplastic pathologic findings in nephrectomy specimens; postoperative renal insufficiency and outcomes
Authors: Shaw Nathan M , Hill Frank C. , Bakios Lauren , Krishnan Jayashree , Venkatesan Krishnan , Verghese Mohan
Published: February 2020

Introduction: Incidence of renal masses has increased with increased abdominal imagings. The trend in treatment of renal masses has been toward renal preserving options, including surveillance, ablation and partial nephrectomy. Objectives: To determine the frequency of medical renal disease in patients undergoing surgical intervention for renal neoplasms and to establish whether these pathologic changes predict development of renal insufficiency in the immediate postoperative period. Patients and Methods: This was an Institutional Review Board (IRB)-approved retrospective review of all patients that underwent radical nephrectomy (RN), partial nephrectomy and nephroureterectomy from December 2009 to November 2013. Around 225 patients had complete pathologic and perioperative data for analysis. We compared preoperative and postoperative glomerular filtration rate (GFR), neoplastic findings, tumor characteristics (positive margins and extracapsular extension), and pathology information regarding non- neoplastic findings (tubular atrophy, chronic inflammation and fibrosis). Results: The presence of any pathologic abnormalities in the non-neoplastic renal parenchyma was significantly associated with increased serum creatinine levels postoperatively (P=0.01) and at last follow up visit (P=0.04). Univariate analysis showed that glomerular and vascular abnormalities were each significantly associated with worsening renal function. Conclusion: Our research suggests that abnormalities in non-neoplastic renal parenchyma found in renal specimens after RN should not be ignored as they may predict possible worse outcomes in renal function. This may help make a case for biopsy pre-operatively and a stronger case for nephron sparing surgery. This may also help determine which patients should be followed more closely postoperatively.
Asymptomatic Bacteriuria in Type II Diabetics and non Diabetics: Risk factors, Bacterial types and their corresponding resistance pattern
Authors: Abujheisha Khalil Y.
Published: February 2020

Introduction: Silent Bacteruria or asymptomatic bacteriuria (ASB) means the existence of bacteria in urine without clinical signs or symptoms of the host. Both diabetic and non diabetic patients have the possibility of urinary tract infections with or without symptoms. Bacteria cause asymptomatic bacteriuria are colonizing flora which usually arise from the vagina, gut, or periurethral area. The risk of asymptomatic bacteriuria is greater among diabetic and non-diabetic patients particularly women. Asymptomatic bacteriuria is considered clinically significant and worth treating primarily in pregnant women. Objectives: In this study, we examined the silent bacteriuria among diabetics and healthy persons, type of strains, and their corresponding resistance pattern. Materials and Methods: A total of 220 diabetic patients and 70 healthy persons were subjected to study. Diabetic patients without malignancies, asthma or heart diseases, symptoms free regarding urinary tract infection and without prior antibiotic administration were included. Blood sample obtained from all subjects study under aseptic technique for fasting blood sugar and HbA1C. Urine samples were collected, All urine samples were passed to cultivation on suitable culture media. Plates of more than two clinical isolates from the same patient were considered to be contaminated. Plates showing more than 104 CFUs/ mL were considered significant ASB and subjected for confirmation of bacterial type and antibiotic susceptibility test. Results: From diabetics urine samples, 21(9.55%) and from healthy persons 3(4.3%) showed significant bacterial growth. In both diabetics and non-diabetics, women demonstrated a far higher prevalence of ASB than men. The high the HbA1c, the more possibility of positive ASB. In 66,7% of ASB, E. coli was the main uropathogens, followed by K. pneumoniae. These species showed identical antibiotic resistance patterns. Conclusion: These findings emphasize the importance of routine urine culture and antibiotic sensitivity testing for diabetic patients who have risk factors identified. ASB should be treated in order to avoid potential serious renal complications. Amikacin, Gentamicin, Piperacillin/Tazobactam, Fosfomycin, and Ciprofloxacin are recomended for treatment of ASB while Ampicillin is not.
The discrimination of acute tubular necrosis and prerenal azotemia using two biomarkers simultaneously
Authors: Zeraati Abbas Ali , Sahihi Farnaz , Lotfi Zahra , Mamdouhi Freshteh , Sharifipour Farzaneh , Zeraati Tina
Published: February 2020

Introduction: The fractional excretion of sodium (FE Na) in urine has appeared as a helpful way to distinguish prerenal azotemia from acute tubular necrosis (ATN). Objectives: The urinary index of sodium has some limits. Lithium can be an additional careful indicator. The goal of our study was to assess the standards fractional excretion of sodium and lithium, (FE Na and FE Li) in distinguishing pre-renal azotemia (PRA) from ATN. Patients and Methods: Twenty-seven patients with prerenal azotemia, 25 patients with ATN and 20 healthy persons were included in this investigation. The plasma and urine sodium, creatinine and lithium levels were assessed. Additionally, FE Na and FE Li were calculated. To assess the diagnostic usefulness of FE Na and FE Li in discriminating prerenal azotemia from ATN, we created a receiver operating characteristic (ROC) curve. Results: The area under the curves (AUCs) of fractional excretion of Li and Na were 0.84 and 0.83 for distinguishing prerenal azotemia from ATN, respectively. There was a significant direct association between FE Na and FE Li in patients with ATN (P=0.001). No significant association of FE Na and FE Li in patients with prerenal azotemia was detected (p=0.26). By a cutoff point of 2.96%, the sensitivity and specificity for FE Na, were 68% and 75%, respectively for distinguishing PRA from ATN. By a cutoff point of 4.17%, the sensitivity and specificity of FE Li were 80% and 79%, respectively, for distinguishing prerenal azotemia from ATN. Conclusion: This investigation appeared a high AUC and accuracy of fractional excretion of sodium and lithium as a diagnostic method for distinguishing prerenal azotemia from ATN when used simultaneously. However, the discrimination of sensitivity and specificity of fractional excretion of lithium was greater than the fractional excretion of Na.
The therapeutic efficnecy of ranolazine in comparison with conventional therapy in diabetic individuals with ischemic heart disease; a randomized clinical trial
Authors: Fariborz Farsad Bahram , Alavi Seyed Mostafa , Ghorbanian Golshid , Fahimi Fanak , Ghaemmaghami Zahra , Zahed Mehr Ali , Bakhshandeh Hooman
Published: February 2020

Introduction: Patients with diabetes mellitus (DM) have higher risk of coronary artery disease (CAD) and angina than the general population. Objectives: We sought to assess the impact of ranolazine as an antianginal agent to diminish hemoglobin A1c (Hb A1c) level in diabetic individuals under treatment with metformin and gliclazide. Patients and Methods: This study was a randomized parallel-group clinical trial to compare the therapeutic effects of ranolazine versus conventional treatment in patients with concomitant T2DM and stable angina. TERISA (type 2 diabetes mellitus evaluation of ranolazine in subjects with chronic stable angina) was employed to assess the efficiency of ranolazine in lowering the frequency of angina attacks. The study was performed on diabetic patients with symptomatic angina under treatment with either sublingual nitroglycerin or up to two types of antianginal agents. The patients in the intervention group received 1000 mg ranolazine twice a day while patients in the control group were administrated with conventional treatment. Reduction in baseline Hb A1c level was determined at 4 and 8 weeks after the interventions. Results: Ranolazine therapy resulted in up to 15% absolute reduction in Hb A1c level in diabetic patients who had baseline HbA1c level >7%. Ranolazine was more efficient in reducing Hb A1c in patients with poorly controlled disease (i.e. HbA1c>8%, P=0.017). Ranolazine did not affect the glycemic status of patients concomitantly treated with antidiabetic therapy (P=0.560). Conclusion: Concurrent administration of ranolazine along with anti-diabetic treatments (i.e. metformin and gliclazide) was safe to reduce the level of HbA1c in patients with poorly controlled diabetes and stable angina.
A case report of renal vein thrombosis following whiplash by husband with review article
Authors: Zahirian Moghadam Telma , Mohseni Rad Hamed
Published: February 2020

Renal vessel thrombosis results in kidney loss unless be re-vascularized immediately. We report a case of right renal vein thrombosis in a 43 years old woman following whiplash trauma by her husband without any associated parenchymal or arterial injury. She presented to our emergency center with right flank pain for three days. She reported whiplashing by her husband 3 days before admission. Abdominopelvic spiral computerized tomography (CT) with intra-venous contrast showed a non-enhancement, enlargement and peri-renal fat-stranding in the right kidney. With the diagnosis of renal vein thrombosis following whiplash, the patient was heparinized 5000 IU sub-cutaneous every 8 hours and discharged with warfarin after resolution of gross hematuria. Follow-up with nuclear scan 10 weeks later showed the right kidney is non-function.
Impact of vitamin D deficiency on health with regard to kidney disease; an updated mini-review
Authors: Dorestan Nozar , Bahadoram Sara , Bahadoram Mohammad , Khosravi Mohammadreza , Davoodi Mohammad , Hasanpour Dehkordi Ali , Khazaei Zaher , Amiri Masoud
Published: February 2020

Vitamin D or cholecalciferol, as a steroidal hormone, regulates the calcium homeostasis, and bone formation with reabsorption through kidneys, parathyroid glands and bowel. There are at least 800 human genes connected with vitamin D. Previous research has confirmed the relationship between vitamin D and colorectal cancers, infections, heart diseases, multiple sclerosis (MS), bone disorders, inflammatory and autoimmune diseases, inflammatory bowel diseases, diabetes mellitus type-I and II and also progression of kidney disease. However, the relationship of vitamin D deficiency and developing of breast cancer, rheumatoid arthritis and osteoporosis is unknown. In fact, the effect of vitamin D deficiency on pathogenesis of different diseases is controversial. To cope with vitamin D deficiency, there are different recommendations such as daily intake of vitamin D supplements and more exposure to sunlight.
The demise of contrast nephropathy; can this be true? A contrarian view; a representative case report of contrast nephropathy from Mayo Clinic Health System in Northwestern Wisconsin
Authors: Onuigbo Macaulay Amechi , Samuel Eileen , Agbasi Nneoma
Published: February 2020

In the cognate nephrology literature, a few recent publications from major academic centers in the United States have suggested that the incidence of contrast nephropathy was exaggerated and overstated. These investigators have concluded that intravenous contrast material administration was not associated with an increased risk of acute kidney injury (AKI), emergent dialysis, and short-term mortality in a cohort of patients with diminished renal function. As a contrarian opinion, we first describe a clear cut case of contrast-nephropathy resulting in AKI requiring hemodialysis treatment managed in the Renal Unit of the Mayo Clinic Health System, Northwestern Wisconsin, in the Spring of 2017. We subsequently revisit the overwhelming evidence-base in the English literature that supports the enormous impact of contrast-nephropathy as a clinical syndrome. We finally posit that these recent repudiations of the existence and significance of contrast-nephropathy as a significant clinical entity represent an overreach in statistical expertise. There is no basis for a requiem song over contrast-nephropathy
Renal function as a predicting model for plasma methotrexate concentration after high-dose methotrexate chemotherapy in pediatric malignancy
Authors: Jaseb Kaveh , Ghaedi Ehsan , Shahin Mohadeseh , Mirmohamadkhani Majid , Javadian Parisa , Haghi Sabahat
Published: February 2020

Introduction: Methotrexate (MTX) is the most generally administered antimetabolite in pediatric cancers. Renal excretion is the major route of elimination of MTX. However, renal toxicity and delayed MTX elimination is a particular concern and direct serum MTX concentration is a gold standard for renal toxicity monitoring. However, checking plasma MTX concentrations in most oncology institutions is not always possible especially in less developed countries. Objectives: The purpose of this study was to further assess the renal function after administration of high-dose MTX by parameters such as serum creatinine and Cr clearance rate. Patients and Methods: This is a cross-sectional descriptive analytic study. The study was conducted on children with acute lymphoblastic leukemia, non-Hodgkin lymphoma and osteosarcoma receiving high doses MTX. Patients’ age was ranged from 5 to 16 years. Serum MTX concentration and serum Cr were measured at 24, 48 and 96 hours after receiving MTX and then Cr clearance calculated based on available formulas. All the statistical analyses were done by SPSS 20.0 statistical software Results: This study was performed on 4 patients with osteosarcoma, 3 patients with leukemia and one patient with lymphoma. MTX concentration reduced significantly during 96 hours (P<0.001). A significant correlation between Cr clearance at 48 hours and the average of serum MTX concentration (P=0.001) were observed. Furthermore there were significant correlations between Cr at 24 hours (P=0.003), 48 hours (P=0.009) and 96 hours (P=0.044), with the average of serum MTX concentration. Conclusion: Our findings indicated that serum Cr and Cr clearance can be used to estimate the average of serum MTX concentrations.
Gabapentin for treatment of restless legs syndrome among hemodialysis patients; a pilot study
Authors: Mousavi Movahed Seyed Majid , Alizadeh Attar Gholamreza , Hayati Fatemeh , Ahmadi Halili Shahla , Sabetnia Leila , Beladi Mousavi Seyed Seifollah
Published: February 2020

Introduction: Unfortunately the restless leg syndrome (RLS) is a neglected issue among hemodialysis (HD) centers. Objectives: The aim of our study was to find the efficacy of gabapentin at a low dose of 100 mg three times a week among HD patients with RLS. Patients and Methods: Around 21 patients with fulfilled the criteria of RLS were randomized to receive either gabapentin (100 mg) or placebo after HD session for 4 weeks. After 2 weeks of washout period, the patients were switched from gabapentin to placebo or placebo to gabapentin for another 4 weeks. Severity of RLS symptoms before and after management with medication or placebo was evaluated with standardized questionnaire. Results: Twenty-one patients (10 females and 11 males with mean age of 58 years) were enrolled to the study. Before the study, all patients had questionnaire scores of 16 or greater and the mean score was 24.19± 7.96. After gabapentin administration (before or after crossover), the mean score significantly decreased from 24.19± 7.96 to 19.24± 9.87 (P=0.04). The mean score before and after placebo administration (before or after crossover) were 24.19± 7.96 and 18.89± 11.15 with no significant difference (P=0.09). Conclusion: According to the results of the study gabapentin at a dose of 100 mg at the end of HD is a safe effective therapy for RLS. It can significantly reduce the intensity of RLS among these patients.