bluuebunny/crossref_metadata_2025 huggingface dataset:
A comparison of disk diffusion method and E-test in determining the susceptibility and resistance of Klebsiella and Acinetobacter strains to cefepime in patients with ventilator-associated pneumonia admitted to the intensive care unit
Authors: Mahjobipoor Hossein , Sajadi Mehdi , Honarmand Azim , Rahimi-Varposhti Mojtaba , Yadegari Leila , Attarzadeh Ali , Mahjobipoor Laya , Fattahpour Shirin
Published: May 2022

Introduction: Ventilator-associated pneumonia (VAP) which is mostly caused by microorganisms such as Acinetobacter and Klebsiella is one of the causes of death among patients in the intensive care unit (ICU). Objectives: The aim of this study was to compare disk diffusion method and E-test in detecting the susceptibility of Klebsiella and Acinetobacter strains isolated from lung secretions of patients with VAP admitted to the ICU treated with cefepime. Patients and Methods: In this cross-sectional descriptive study, 100 patients with VAP including 55 and 45 cases infected with Acinetobacter and Klebsiella, respectively, according to the antibiogram participated. The susceptibility and resistance of Acinetobacter and Klebsiella strains to cefepime was determined using disk diffusion method and E-test. In addition, kappa test was used to determine the sensitivity and specificity of disk diffusion method compared to E-test. Results: The sensitivity and specificity of the disk diffusion method were 100% and 25%, respectively and its positive predictive value was 87.5% and its negative predictive value was 100%. The kappa coefficient was 0.35 (P<0.0001), which indicates a significant agreement between the two tests. Conclusion: Disk diffusion method has high sensitivity and low specificity in comparison to E-test in determining the resistance and susceptibility of Acinetobacter and Klebsiella strains to cefepime in patients with VAP admitted to the ICU.
Consistency analysis of ultrasound-guided fine-needle aspiration and histopathology results in thyroid nodules
Authors: Bahrami Amir , Valizadeh Soheila , Aghamohammadzadeh Nasser , Najafipour Farzad , Halimi Monireh , Javad-Rashid Reza , Jalili Javad , Houshyar Jalil
Published: May 2022

Introduction: Thyroid nodules are considered as a frequent clinical problem. The great majority of thyroid nodules are benign; however malignancy probability is predicted to be 5-10%. The inconsistency between ultrasonography and fine-needle aspiration (FNA) findings is one of important problems in management of thyroid nodules. Objectives: This study was designed to investigate the consistency of ultrasonography, FNA and histopathology findings in thyroid nodules. Patients and Methods: In this descriptive study, 93 patients who were candidate for thyroid surgery were included. Data on ultrasound-guided fine-needle aspiration of the thyroid and histopathologic results before and after surgery were considered. The Cramér’s V and Fisher’s exact tests were conducted for this study. Results: In patients whose ultrasound (US) results were low-suspicious, we observed a significant correlation between FNA and pathology results (Cramér’s V = 0.574, P = 0.037). However, relationship between FNA and pathology was not accessible among patients whose ultrasonography results were intermediate suspicious or high-suspicious due to insufficient number of samples. Conclusion: In our study, a significant correlation was observed between FNA and pathology results in low-suspicious nodules.
Benralizumab substitution monotherapy in symptomatic relapsing asthma-dominant eosinophilic granulomatosis with polyangiitis
Authors: Onuigbo Macaulay Amechi Chukwukadibia , Libman Bonita , Lazarovich Mark
Published: May 2022

There is increasing interest in biologicals in steroid-resistant or steroid-dependent eosinophilic granulomatosis with polyangiitis (EGPA). We describe successful benralizumab monotherapy in asthma-dominant EGPA. Sixteen years ago, a 38-year-old male was diagnosed with multisystemic illness with asthma, arthralgias, Bell’s palsy and nephrotic syndrome, with 20.3% eosinophilia (absolute count 1160 K/µL), ESR 50 mm/hour, albumin 2.3 g/dL, serum creatinine 1.1 mg/dL, slightly above baseline and negative immunology work. Kidney biopsy demonstrated diffuse podocyte foot process effacement with minimal change disease, without vasculitis and EGPA was diagnosed. He achieved early remission with corticosteroids and intravenous cyclophosphamide and was maintained on prednisone and mycophenolate mofetil. Nevertheless, he repeatedly experienced severe asthma exacerbations, falls in FEV-1% and recurrent relapsing eosinophilia. He was successfully started on benralizumab and was weaned off mycophenolate mofetil and prednisone. Eosinophilia was corrected and FEV-1% normalized. We support calls for larger trials of the biologicals in EGPA.
Saccharomyces boulardii plus azithromycin is superior to azithromycin alone in reducing the duration of diarrhea in children with acute colitis: a double-blind randomized placebo-controlled trial
Authors: Ahmadi Mitra , Mohtasham Neda , Shamsizadeh Ahmad , Javaherizadeh Hazhir , Cheraghian Bahman , Alizadeh Masumeh
Published: May 2022

Introduction: Diarrheal disorders remain a major disease burden throughout the world in pediatrics that remains a health problem. Several treatment methods have been proposed to treat diarrhea, however each of them has some problems. Objectives: The aim of this study was the evaluation the effect of oral Saccharomyces boulardii on the duration and severity of colitis. Patients and Methods: This randomized clinical trial study included ninety-four patients with acute colitis were enrolled. The children were divided randomly into case and control groups. The control group received supportive treatment including intravenous or oral fluid therapy (ORS solution), antibiotic treatment with azithromycin suspension, and zinc sulfate syrup daily for five days. In addition to the mentioned treatments, the intervention group received S. boulardii as a probiotic capsule. Then, the duration and severity of diarrhea based on the Vesikari score were evaluated for all the patients for five first days. Results: The mean of Vesikari score after the first day in both groups was similar, while after the third and fifth day in the probiotic group this score was lower than the control group (5.11 ± 1.73 versus 6.13 ± 2.25, P=0.031 and 2.36 ± 1.16 versus 4.28 ±1.19, P<0.001, respectively). Furthermore, the number of diarrhea per day in the probiotic group was significantly lower after the first day in contrast to the control group, which remains significant at the end of the fifth day (2.32 ± 0.51 versus 2.83 ± 1.23, P=0.047). Moreover, we found that the diarrhea duration (P<0.001), fever duration (P=0.029), and duration of hospitalization (P=0.006) were statistically lower in the case group as compared to the control. Conclusion: Saccharomyces boulardii had a beneficial effect as a probiotic agent in reducing the severity and duration of diarrhea, which could be beneficial for the treatment of colitis. Trial Registration: The trial protocol was approved by the Iranian Registry of Clinical Trials (identifier: IRCT20161026030525N2); https://www.irct.ir/trial/24229; ethical code: IR.AJUMS.REC.1395.54.
Predicting positive anti-thyroid peroxidase antibody chance in vitamin D deficient patients
Authors: Darban Mahboubeh , Doust Mohamadian Soraya , Mahmoodifar Sepideh , Ghorbani Raheb
Published: May 2022

Introduction: The relationship between vitamin D deficiency and thyroid gland disorders is controversial. Objectives: Given the prevalence of vitamin D deficiency and the significance of thyroid disorders, the purpose of the study was to examine the relationship between anti-thyroid peroxidase (anti-TPO) antibody and vitamin D deficiency. Patients and Methods: This cross-sectional study was conducted on 35 patients with vitamin D deficiency and 35 people as a control group with normal vitamin D considered more than 20 ng/mL. Serum TSH and anti-TPO antibody tests were assessed for all subjects in both groups. The level of 25 [OH] D3 less than 20 ng/mL was considered as the deficiency of vitamin D and the serum level of anti-TPO antibody more than 40 IU/mL as positive level. Results: Mean age of patients with vitamin D deficiency was 37.00 ± 13.8 years and 46.3 ± 15.9 years in the control group. Mean age in the two groups was different (P=0.010). Around 51.4% of patients had vitamin D deficiency. There were no significant differences in TSH level among the groups (P=0.436). Anti-TPO antibody (anti-TPO Ab) level in 31.4% of the patients with vitamin D deficiency and in 11.4% of patients in the control group was positive with a significant difference (P=0.041). Logistic regression analysis showed the chance of positive anti-TPO Ab in people with vitamin D deficiency was 3.55% of the subjects without vitamin D deficiency (OR = 3.55, 95%, CI: 1.01-12.55, P=0.049). Conclusion: Considering the greater chance (three-fold) of positive anti-TPO Ab titers in patients with vitamin D deficiency in this study, more interventional studies are suggested concerning the effect of vitamin D deficiency on anti-TPO Ab.
The relationship between serum VCAM-1 level and lupus nephritis in patients with systemic lupus erythematosus
Authors: Musavi Ensieh-Sadat , Mirfeizi Zahra , Mehrad-Majd Hassan , Mousavinik Sara , Samadi Katauoon , Zeraati Abbasali , Sharifipour Farzaneh
Published: May 2022

Introduction: Nephritis is a frequent inflammatory autoimmune complication in systemic lupus erythematosus (SLE). Detecting the nephritis state of SLE patients using non-invasive biomarkers seems to be necessary. Objectives: This study aimed to evaluate role of vascular cell adhesion molecule-1 (VCAM-1) as a noninvasive method in the assessment of lupus nephritis. Patients and Methods: This study was conducted at Imam Reza hospital in Mashhad, Iran, during 2017-2018. A total of 114 SLE patients diagnosed based on the lupus diagnosis criteria including the clinical and paraclinical symptoms that were referred to the rheumatology or nephrology clinics and were enrolled in the study. After obtaining informed consent, a blood sample was taken to determine serum VCAM-1 levels. All patients were evaluated for glomerular hematuria and proteinuria in addition to testing for serum C3, and C4, anti-nuclear antibody (ANA) and anti-ds DNA levels. The serum urea and creatinine levels as well as 24-hour urine protein were measured. Finally, the patients were designed into two groups of SLE with and without nephritis. A renal biopsy was performed in lupus patients with nephritis to determine the class of the disease. The association between serum levels of VCAM-1 and activity of SLE disease [systemic lupus erythematosus disease activity index (SLEDAI)], anti-dsDNA serum level, glomerular hematuria, proteinuria, and lupus nephritis class were evaluated. Results: According to statistical analysis there was no significant relationship between SLEDAI and VCAM-1 levels was detected (P>0.05). Additionally, no significant relationship between VCAM-1 levels and lupus nephritis classes was detected (P>0.05); however the serum VCAM-1 levels were significantly lower in patients with hematuria (P= 0.021). Conclusion: There is no correlation between serum VCAM-1 levels and classes of lupus nephritis. Our data however requires further investigation on its clinical implications.
Tocilizumab in a patient affected by chronic active antibody mediated rejection; histological improvement, reduction of proteinuria and renal function stabilization
Authors: Panaro Laura , Trezzi Matteo , Ardini Michela , Marchini Michele , Delsante Marco , Rolla Davide
Published: May 2022

Introduction: Chronic active antibody-mediated rejection (cAMR) is a significant and rapid destructive form of allograft rejection and it is related to donor specific antibodies (DSA). Interleukin 6 (IL-6) plays an important role in mediating the allograft rejection by promoting CD4+ T cells differentiation to Th17 phenotype while inhibiting Treg. Tocilizumab is a humanized monoclonal antibody directed to IL-6 receptor (IL6-R). The aim of the study is to demonstrate the efficacy of tocilizumab as rescue therapy for cAMR. Case Presentation: A 50-year-old man with Alport syndrome and with positive DSA against B7 e B55 underwent a second kidney transplant (HLA 2 mismatch). He received thymoglobulin and three plasma exchanges as induction therapy. Proteinuria (1-1.3 g/24 h) and decline in kidney function (serum creatinine; 1.5 mg/dL) appeared at 9 months. Kidney biopsy showed endocapillary proliferation, mononuclear cells infiltration, glomerular basal membrane duplication and tubulitis suggestive of cAMR. The patient has been treated with tocilizumab (6 mg/kg/mon) for six months. Reduction of proteinuria (0.6 g/24 h) and mild improvement of kidney function (serum creatinine; 1.3 mg/dL) were observed after tocilizumab treatment. A second biopsy revealed a significant decrease of glomerulitis and peritubular capillaritis. A significant reduction in DSA was detected. Conclusion: Inhibition of the IL-6 receptor by tocilizumab may represent a novel and cheering approach to treat cAMR.
Pregnant kidney transplant recipients with COVID-19; a report of two cases and literature review
Authors: Domingos Ana , Braga António , Gonçalves Daniela , Pedroso Sofia , Martins La Salete , Braga Jorge
Published: May 2022

If managing COVID-19 alone was a major challenge, one can expect an even greater challenge in certain scenarios, such as patients with kidney disease - including kidney transplant recipients (KT) – or pregnant women. When things could not get any worse, we just met the peculiar art of overcomplicating things: pregnant kidney and simultaneous kidney-pancreas (SKP) transplant recipients with COVID-19. Gleeson and colleagues (Imperial College, London) described the first similar case in April 2020. We describe two cases of pregnant KT and SKP transplant recipients with COVID-19, at different stages, and their evolution until delivery. Maternal and fetal outcomes are significantly affected by both KT and COVID-19, requiring a multidisciplinary approach with a well-trained team of obstetricians and nephrologists, as we will describe.
Neutropenia associated with proximal renal tubular dysfunction and mild bilateral cataract
Authors: Naseri Mitra , Farhangi Hamid , Attaran Zadeh Armin , Ghoroneh Zeynab
Published: May 2022

We report an 11-year-old girl admitted to nephrology section due to growth failure, neutropenia, renal glycosuria, and proteinuria and also hypophosphatemic rickets. She had a history of repeated hospitalization because of respiratory or gastrointestinal infections. Bone marrow aspiration revealed hyper-cellular bone marrow with mild dysplastic pattern. Eyes examination showed mild bilateral posterior cataract. X-ray of the wrist demonstrated a bone age of 3.5 ±6 months with evidence of rickets. We could not find a syndrome that can explain these associations.
Ameliorative impact of hydroalcoholic extract of Clove buds (Syzygium aromaticum) on contrast-induced acute kidney injury; an experimental histopathological study
Authors: Nasri Parto , Hooshyar Niloufar , Yalameha Banafsheh , Akafzadeh Savari Mahsa , Khosravifarsani Mohammadreza , Mardani Saied , Noorshargh Pegah , Hasanpour  Dehkordi Ali , Nasri Hamid , Golestaneh Elnaz , Bijad Elham , Ghasemi Behzad , Nowrouzi Nafiseh
Published: May 2022

Introduction: The administration of iodinated contrast medium is extensive in various imaging techniques including coronary angiography. Objectives: The present investigation was designed to examine the ameliorative effect of clove buds (Syzygium aromaticum) on contrast-induced acute kidney injury (CI-AKI) in rats Materials and Methods: Forty male Wistar rats with a mean body weight of 200-250 g were studied. Rats randomly assigned into four groups, 10 rats for each; Group 1; normal rats (control group; sham group); they did not receive any drugs. Group 2; rats were received 10 mL/kg as a single dose of iodixanol (contrast media) by intravenous (IV) injection. Group 3; rats received 10 mg/kg clove by intraperitoneal (IP) injection for three days, while in day forth, they received a single dose of iodixanol (10 mL/kg). Group 4; rats of this group first received a single dose of iodixanol (10 mL/ kg). Then rats treated by clove (10 mg/kg) by intraperitoneal (IP) injection for three days (days 2, 3 and 4th). Kidney sections were examined for degeneration, flattening, and necrosis of renal tubular cells and also dilatation of tubular lumen. Results: We found a significant difference between groups regarding the sum of injury (degeneration, flattening, necrosis and dilatation). A significant difference in types of injury (degeneration, flattening, necrosis and dilatation) among the groups (P=0.001) was seen too. We detected a significant difference between groups II (contrast media) and III (rats pretreated by clove; P<0.001). Accordingly, we detected a significant difference between groups II (contrast media) and IV (rats post-pone treated by Clove buds; P<0.001) too. There was not a significant difference between groups of III and IV (P> 0.05). Conclusion: In this animal study, we found that post-pone treatment of clove was as effective as pretreatment to mitigate the injury induced by contrast media.
Effect of sodium hydrogen sulfide (NaHS) on contrast-induced acute kidney injury; an experimental histopathological study
Authors: Nasri Parto , Noorshargh Pegah , Hooshyar Niloufar , Akafzadeh Savari Mahsa , Yalameha Banafsheh , Golestaneh Elnaz , Khosravifarsani Mohammadreza , Mardani Saied , Hasanpour Dehkordi Ali , Baradaran Azar , Bijad Elham , Ghasemi Behzad , Nowrouzi Nafiseh
Published: May 2022

Introduction: Contrast-induced nephropathy (CIN) is associated with a minimum increase of 25% of the creatinine base or an increase in creatinine of 0.5 mg/dL during 2-3 days after the administration of the contrast agent Objectives: The present investigation was designed to examine the effect of sodium hydrogen sulfide (NaHS) on contrast-induced acute kidney injury in rats. Materials and Methods: Forty male Wistar rats randomly assigned into four groups, 10 rats for each group. Group 1; normal rats (control group; sham group); they did not receive any drugs. Group 2; rats were received 10 mL/kg as a single dose of iodixanol (contrast media) by intravenous (IV) injection. Group 3; they received 10 mg/kg of NaHS by intraperitoneal (IP) injection for three days, while in day forth, rats received a single dose of iodixanol (10 mL/kg). Group 4; rats of this group, first received a single dose of iodixanol (10 mL/kg). Then rats were treated by NaHS (10 mg/kg) by intraperitoneal (IP) injection for 3 days (days 2, 3 and 4).The kidneys were removed immediately after sacrificing and prepared for morphological examination. Kidney sections were examined for intensity of kidney damage by examination for degeneration, flattening, and necrosis of renal tubular cells and also dilatation of tubular lumen. Results: We detected a significant difference between groups regarding the morphologic variables of damage (P=0.001; one-way ANOVA). A significant difference of morphologic variables of damage (degeneration, flattening, necrosis, and dilatation) among the groups was seen too (P=0.001; one-way ANOVA). The study showed a significant difference between groups II (contrast media) with III (rats pretreated by NaHS) (P<0.001). Moreover, we detected a significant difference between groups II (contrast media) and IV (rats post-pone treated by NaHS) (P<0.001). However, there was not a significant difference between the groups of III and IV (P>0.05). Conclusion: Post-pone treatment of NaHS was as effective as the pretreatment to mitigate the renal damage induced by contrast media.
Metabolomics in lupus; opportunities and challenges
Authors: Afshari Sara , Kalhor Narges , Alavi Seyed Mojtaba , Montazeri Seyed Mohammad Hashem , Masoumi Maryam
Published: May 2022

Systemic lupus erythematosus (SLE) is characterized by an inappropriate autoimmune response to self-antigens. This disease is a heterogeneous autoimmune disease that shows variable clinical course. Metabolomics employs advanced analytical chemistry techniques to comprehensively measure many small molecule metabolites in biological cells and tissues. Metabolites are downstream of translation processes and are thought to be associated with disease phenotypes. This technology is recognized as a powerful tool with excellent potential for detecting prognostic and diagnostic biomarkers in rheumatic diseases. In this review; we summarized the recent available results of studies on metabolomics in lupus and the importance of metabolomics in the finding of diagnostic and prognostic biomarkers was investigated.
Clinical characteristics and cardiovascular risk factors associated with clinical outcome in hospitalized patients with COVID-19
Authors: Masoumi Gholamreza , Mansouri Mojtaba , Shahbazi Masoud , Golshiri Parastoo , Mohammadi Keivan , Rahimirigi Neda
Published: May 2022

Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a new coronavirus, was originally recognized as a pandemic by the WHO on early, a new coronavirus, was originally recognized as a pandemic by the WHO on early 2020, and has infected over 243 million people worldwide, killing about five million people between then and October 2021. Objectives: We investigated the relationship between clinical characteristics, cardiovascular risk factors and echocardiographic findings and in-hospital outcomes of patients who were admitted for COVID-19. Patients and Methods: A retrospective review of 216 hospitalized patients with COVID-19 who were admitted to Chamran hospital from March 2019 to April 2021 was conducted. Patients’ characteristics cardiovascular risk factors, echocardiographic findings, clinical outcomes (discharge (complete recovery/ partial recovery) and in-hospital mortality) were recorded. To analyze risk factors associated with outcomes in patients with COVID-19, univariate and multivariate ordinal logistic regression models were conducted. Results: The most common underlying diseases in patients were hypertension (HTN) (57.9%) and diabetes mellitus (DM) (37.9%), respectively. Cognitive disorders (20.8%) and mitral regurgitation (MR) were the most complication and echocardiographic finding of the patients. In our study, six variables were found to be associated with patient’s outcomes, including age, body mass index (BMI), DM, chronic pulmonary diseases, number of hospitalization days and number of an intensive care unit (ICU) admission days. Conclusion: Our analysis suggests that age, male gender, BMI, number of hospitalization days and ICU admission, chronic pulmonary disease and diabetes are associated with a higher risk of in-hospital mortality and worst prognosis in patients infected by SARS-CoV-2.
Effect of animal versus plant omega-3 polyunsaturated fatty acids on serum level of fetuin-A in patients with chronic renal failure; a randomized double-blinded parallel clinical trial
Authors: Khodadustan Elham , Jafari Tina , Mahmoodnia Liela , Karami Mohammad , Momeni Ali , Dehkordi Ali Hasanpour , Memarzadeh Mohammad Reza
Published: May 2022

Introduction: Low levels of fetuin-A in patients with chronic kidney disease (CKD) are associated with arterial stiffness, vascular calcification and cardiovascular mortality. Objectives: The aim of the present study was to investigate and compare the effect of omega-3 supplements with plant (flaxseed) and animal origins on fetuin-A levels in patients with chronic renal failure. Patients and Methods: In the present clinical trial, 90 patients with chronic renal failure (chronic kidney disease) were randomly divided into three groups. The first group received two grams of omega-3 tablets per day of animal origin (fish oil), the second group received 2 g of omega-3 tablets per day of plant origin (flaxseed oil), and the third group received one placebo per day as the control group. The duration of the drug treatment was 90 days. Before and after the intervention, blood levels of fetuin-A, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C) and triglyceride (TG) were determined. Data were analyzed by SPSS statistical software. Results: Before and after the intervention, LDL-C and HDL-C levels were not significantly different in the study groups. In the animal origin omega-3 group, the levels of triglycerides and cholesterol decreased significantly after the intervention compared to before the intervention (P=0.004), however they did not change significantly in the plant origin omega-3 and control groups. Before and after the intervention, fetuin-A and ESR levels were not significantly different in the study groups. The frequency of positive CRP results in the animal and plant origin omega-3 groups was 20% and 24% respectively before intervention and 4% and 24% after intervention respectively, indicating a decrease in the levels of CRP in the animal origin omega-3 group. Conclusion: Animal origin omega-3 is more effective in reducing serum lipids and CRP than plant-origin omega-3. Omega-3 supplements of plant or animal origin have been more effective in men than in women.
Circulating and cellular levels of miR-193 and miR-217 in patients with common glomerular diseases
Authors: Abediazar Sima , Mostafavi Soroush , Razavi Mahsa , Rasi Hashemi Seyed Sadroddin , Hejazian Seyyedeh Mina , Jabbari Roya , Zununi Vahed Sepideh , Khalilov Rovshan , Noshad Hamid , Ardalan Mohammadreza
Published: May 2022

Introduction: The definitive diagnosis of the common types of glomerular disease including FSGS (focal segmental glomerulosclerosis) and MN (membranous nephropathy) is still performed by biopsy studies, which has high risks and complications. MicroRNAs (miRNAs) can open a new horizon for the treatment and diagnosis of glomerular diseases. Objectives: In the present study, we focused on miR-217, miR-193-3p, and miR-124 expression in patients with FSGS and MN. Patients and Methods: Sixty cases (30 FSGS and 30 MN) were included based on strict criteria. A group of healthy controls were also included. The relative expression of the microRNAs was evaluated in the plasma and peripheral blood mononuclear cells (PBMCs) by quantitative real-time PCR. The association between the expression levels of microRNAs and clinicopathological parameters were also assessed. Results: There were significant differences in miR-193-3p levels between FSGS and MN group in plasma samples (P = 0.036). Furthermore, significantly decreased levels of miR-217 were observed in plasma samples of patients with NS (P = 0.026) and MN (P = 0.036) groups. Conclusion: The studied miRNAs are dysregulated in clinical samples of patients with nephrotic syndrome and they may be involved in the pathogenesis of FSGS and MN. More research is needed for understanding the relationship between these microRNAs and the pathogenesis of FSGS and MGN.
Comparison of the effects of potassium citrate and hydrochlorothiazide on the ureteral stent encrustation in patients with long stent survival; a single-blinded clinical trial
Authors: Farshid Saman , Roshandel M. Reza , Tehranchi Ali , Ranjbar Hadi , Valizadeh Rohollah
Published: May 2022

Introduction: The probability of encrustation after embedding ureteral stent is 9.6% in six weeks, 47.5% in 6 to 12 weeks and 76.3% in more than 12 weeks. Objectives: This study was designed to evaluate the effect of potassium citrate and hydrochlorothiazide on ureteral stent encrustation as a single-blinded clinical trial. Patients and Methods: After embedding ureteral stent in 130 patients, the individuals were randomly divided into two groups using random allocation software. Convenience sampling method was used in this study. One group was given hydrochlorothiazide and potassium citrate, and the other group did not receive any medication. All stents were the same brand and the maximum time of stents being in situ was six weeks. Four to six weeks after stent implantation, patients were referred for stent removal. Then, ureteral stent encrustation was recorded in the two groups according to the visual appearance and the difficulty in stent removing due to stent encrustation. Results: The mean age of the patients was 42.62±14.86 years. Regarding gender, 78 patients (67.8%) were male and 37 patients (32.2%) were female. In this study, 15 patients (13%) had ureteral stent encrustation, of which 13 patients (20%) were in the group without medication and two patients (4%) were in the group who received hydrochlorothiazide and potassium citrate (P = 0.012). Conclusion: The rate of ureteral stent encrustation in the patients who received hydrochlorothiazide and potassium citrate was significantly lower than the patients in the control group. This can be justified by the diuretic properties of hydrochlorothiazide and the reduction of urinary calcium levels. Additionally, high urinary citrate level and induction of urinary alkalization after the administration of potassium citrate. Are the ameliorating factors. Trial Registration: Registration of trial protocol has been approved by Iranian Registry of Clinical Trials (identifier: IRCT20180625040232N3, https://en.irct.ir/trial/46227, ethical code# IR.UMSU. REC.1396.130).
Impact of mupirocin and betadine-impregnated urethral catheter on the incidence rate of catheter-related bacteriuria and urinary tract infections, in comparison with conventional catheterization
Authors: Hafizi Masoud , Rajaei-Isfahani Mohammad , Noorian Kobra , Qorbani Amir
Published: May 2022

Introduction: One of the most common nosocomial infections is urinary tract infection (UTI), which more commonly seen in patients with urethral catheter. Inappropriate use of urinary catheter can lead to certain complications including infection. Objectives: The aim of this study was to evaluate the effect of using mupirocin and betadineimpregnated urethral catheters in comparison with conventional catheterization on the incidence rate of catheter-related bacteriuria (CRB) and UTIs. Patients and Methods: In this parallel randomized clinical trial, phase III, a total of 150 patients (male and female) ranging from 18-75 years who needed urinary catheterization were randomly assigned into three evenly distributed groups; betadine, mupirocin, and conventional (control) through permuted block randomization. Sterile urine samples were examined for bacteriuria after catheter insertion and at the time of catheter removal. Results: The mean age of the patients was 49.81 (±15.11) years. UTI was seen most frequently in the conventional group (56%), and least frequently in the mupirocin group (24%) (P<0.004). A significant difference was observed in incidence of post-catheterization UTI between the conventional and mupirocin groups, as well as between the conventional and betadine groups (P=0.001 and P=0.04, respectively). Conclusion: Using antibiotic and antiseptic-impregnated catheters (both mupirocin and betadine) could help to decrease the incidence rate of UTI in comparison to the conventional catheterization. Trial registration: The trial was registered with the TCTR ID: TCTR20200627001 (http:// www.clinicaltrials.in.th/index.php?tp=regtrials&menu=trialsearch&smenu=fulltext&task=s earch&task2=view1&id=6442).
The association between platelet to lymphocyte ratio and neutrophil to lymphocyte ratio with inflammatory factors in hemodialysis patients
Authors: Ghorbani Maryam , Kia Maryam , Razzaghi Maedeh
Published: May 2022

Introduction: Chronic inflammation is a major factor in the pathogenesis of atherosclerosis in hemodialysis patients compared to healthy individuals. Chronic inflammation is part of the malnutrition, atherosclerosis, and inflammation syndrome in advanced renal failure. Objectives: In this study, the relationships of platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) with the inflammatory factors were investigated. Patients and Methods: This cross-sectional study was conducted on 108 hemodialysis patients who were on dialysis for more than three months. For patients, serum levels of urea, creatinine (Cr), sodium, potassium, calcium, phosphate, parathyroid hormone, total cholesterol, triglyceride, ferritin, 25-hydroxy vitamin D, albumin, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and complete blood cell count were assessed before dialysis since serum urea was examined again after dialysis too. Results: The mean age of the patients (58 male and 50 female) was 63.43±14.65 years. The median values for NLR and PLR were 2.25 and 114.7, respectively. ESR was significantly higher in hemodialysis patients with NLR >2.25 (46.7±29.7 versus 36±22.7) and in those with PLR >114.7 (47.09±27.8 versus 35.6±24.8). Plasma hemoglobin and serum 25-hydroxy vitamin D levels were observed to be lower (10.37±1.6 versus 11.7±1.8 and 33.1±2.5 versus 37.9±15.2) in patients with PLR >114.7. Bivariate correlation showed that PLR and NLR had positive significant correlation with ESR while PLR had a significant negative correlation with values of blood 25-hydroxy vitamin D hemoglobin and Cr. Conclusion: Due to availability and affordability of PLR and NLR, they could be used for early assessment of inflammation in end-stage renal disease (ESRD) patients. PLR may be better predictor than NLR (to detect inflammation.
Expression profile of miR-15 and miR-16 in peripheral blood mononuclear cells of patients with steroid-resistant nephrotic syndrome
Authors: Zununi Vahed Sepideh , Ghiyasvand Shahram , Hejazian Seyyedeh Mina , Shoja Mohammadali M. , Ardalan Mohammadreza
Published: May 2022

Introduction: Steroids are considered first-line therapeutic opportunities in cases with idiopathic nephrotic syndrome (INS). The trustworthy biomarkers for steroid-resistant NS (SRNS) would permit more precise decisions in the treatment of INS. Objectives: This study aimed to evaluate the miR-15 and miR-16 levels in NS cases. Patients and Methods: Adult cases with primary NS (n=60) including 30 FSGS (Focal segmental glomerulosclerosis) and 30 membranous glomerulonephritis (MGN) patients and 24 healthy individuals were included. The evaluation of miR-15 and miR-16 expression in blood cells was performed using real-time polymerase chain reaction (qPCR). Moreover, gene ontology analysis and prediction of the miRNA targets were completed to recognize the biological procedures and signaling pathways involved in the pathophysiology of NS. Results: A significant increase was observed in miR-15a-5p expression in cases with primary MGN and FSGS compared with healthy subjects. Conversely, the miR-16-5p expression was significantly decreased in both conditions compared with healthy controls. In the clinical subdivision of FSGS group to steroid-resistant-FSGS and steroid-responsive-FSGS, significant elevated levels of miR-15a-5p and diminished levels of miR-16-5p were observed in both groups compared to normal controls. Gene annotation demonstrated that these miRNAs contribute to cell cycle, ion transport, biological adhesion, cation transport, cellular response to endogenous stimulus, and regulation of small GTPase-related signal transduction. Conclusion: Dysregulated levels of miR-15 and miR-16 may be involved in the pathogenesis and response to steroid therapy in patients with INS.
Electrolyte imbalance in patients with COVID-19 pneumonia
Authors: Sadeghi Somayeh , Keivany Elaheh , Naderi Zohre , Purajam Samane , Nasri Elahe
Published: May 2022

Introduction: Electrolyte abnormalities are among the most common complications among the patients admitted with coronavirus disease 2019 (COVID 19) pneumonia and maybe contributed to its course of disease and severity. Objectives: The current study aims to assess the prevalence and association of electrolyte imbalance among patients with COVID 19 pneumonia. Patients and Methods: The current observational study has been conducted on 323 patients with COVID 19 pneumonia. On-admission blood samples were taken to assess electrolytes (sodium, potassium, calcium, and magnesium), complete blood count and differentiation (CBC with diff), and other biomarkers. Further measurements of electrolytes were conducted during the period of hospitalization if needed. The frequency and association of electrolyte imbalance with diverse demographic, clinical, laboratory, and in-hospital characteristics was assessed. Results: Hypo/hypernatremia, hypo/hyperkalemia, hypo/hypermagnesemia and hypo/ hypercalcemia were presented in 14.5%/9.4%, 3.8%/10.3%, 7.9%/9.3%, and 10.9%/10.8%, respectively. Time to discharge was remarkably higher among the patients with hypernatremia (P=0.031). The patients with hypermagnesemia were significantly younger than the other cases (P=0.016). The C-reactive protein (CRP) level was statistically less among the patients with hypercalcemia (P=0.025). There was no associative outcome between potassium abnormalities and patients’ characteristics. Conclusion: The present study showed that electrolyte imbalances are common laboratory abnormalities during COVID-19. However, we found no associative role, since ions balance plays a crucial prognostic role for COVID-19.
Effect of rituximab on reducing the panel-reactive antibody in dialysis patients of transplant candidate
Authors: Aref Asieh , Tirom Samaneh , Shahbazian Heshmatollah , Ghorbani Ali
Published: May 2022

Introduction: Based on the evidence, rituximab may be an effective treatment for kidney transplantation for reducing panel-reactive antibody. Objectives: This study was conducted to investigate the effect of rituximab on reducing the panel in transplant dialysis patients. Patients and Methods: This is an interventional study that was conducted on 20 dialysis patients who were candidates for kidney transplantation. Patients first had a panel-reactive antibody test and patients with a panel-reactive antibody above the age of 30 were included in the study. First, rituximab was administered at a dose of one gram and then after two weeks, another dose of one gram was administered. Panel-reactive antibody was measured baseline, one and six months later. Results: One and six months after stopping the drug, we found a significant decrease in the mean amount of reactive antibodies. Additionally, six months after stopping the drug, a significant decrease in the level of patients’ reactive antibodies in comparison to one month before taking the drug was detected (P<0.05). Conclusion: The findings showed that treatment with rituximab is useful for reducing panel-reactive antibody in kidney transplant patients. However, more studies are needed to optimize rituximab injection protocols.
Pattern and prevalence of different findings in high resolution computed tomography images in patients with coronavirus disease and kidney injury; a pilot study
Authors: Dalili Amir-Reza , Ramezanzadeh Elham , Soleimani Farsani Fahime , Saffari Elahe , Vakilpour Azin , Mohammadyari Eshagh , Samiee Sara , Namdar Masumeh
Published: May 2022

Introduction: Since December 2019, an outbreak of pneumonia caused by a new coronavirus has emerged. The standard diagnostic method for COVID-19 infection is the real-time reverse transcriptase-polymerase chain reaction (RT-PCR). High-resolution computed tomography (HRCT) has been proven as a sensitive, feasible and accessible test in Iran. In addition to respiratory system, other organs could also be involved in this disease. The exact mechanism of renal involvement is unknown; however, acute kidney injury (AKI) occurs in almost 5-15% of cases. Different HRCT patterns might be associated with AKI presence and severity of the disease. Objectives: To investigate patterns and prevalence of different HRCT findings in COVID-19 patients with concurrent AKI. Patients and Methods: In this retrospective study, we reviewed all hospitalized patients with COVID-19 infection, from February to April 2020 in Razi hospital, Rasht. Twenty-two cases who had AKI were enrolled. The HRCT findings of the patients were reviewed independently by two radiologists. Percentage and prevalence of HRCT findings were analyzed in SPSS 21 software. Results: All 22 cases had multifocal distribution on HRCT. Around 95.5% had peripheral involvement, 86.4% had central zones opacity while 72.2% of cases had peribronchovascular pattern. Bilateral lung involvement was found in 90.9%, but only 9.1% had unilateral involvement. There was 59.1% of lower lobe predominance for COVID-19 involvement since sub-pleural regions were spared in 18.2% of individuals. All the patients’ HRCTs showed ground glass opacity. Reticular pattern (81.8%), consolidation (77.3%), vascular enlargement in involved zones (68.2%) and airway changes (68.2%) were the next more prevalent findings. Half of the subjects showed crazy paving, 45.5% had pleural effusion and 13.6% had also lymphadenopathy. We found 40.9% of the patients had arcade-like sign. Less frequent findings were nodular opacities (13.6%), halo sign (9.1%) and reverse-halo sign (9.1%), respectively. Conclusion: This study demonstrated that atypical patterns are likely to be more common in COVID-19 patients with kidney injury.
Urinary neutrophil gelatinase-associated lipocalin might be an associated marker for anticipating scar formation in children with vesicoureteral reflux
Authors: Amiri Rahimpour , Raeisi Roya , Amiri Jalaleddin , Sheida Fateme , Mohammad Alizadeh Ziba , Solgi Ghasem , Bazmamoun Hassan , Faradmal Javad , Hasanpour Dehkordi Ali
Published: May 2022

Introduction: Vesicoureteral reflux (VUR) is considered as the most common urogenital abnormality occurring in children. There is no reliable and routine clinical test that is non-invasive and rapid for recognizing the renal scars from VUR. Objectives: Urine neutrophil gelatinase-associated lipocalin (uNGAL) can be the best indicator for early diagnosis of scar formation in children with VUR. Patients and Methods: Children with primary VUR admitted to Hamadan’s Besat hospital from March to December 2020 were included in this cross-sectional study. A dimercaptosuccinic acid (DMSA) scan was employed to assess all subjects in order to diagnose scar formation at least 180 days after the last episode of urinary tract infection (UTI). Additionally, uNGAL and its ratio to urine creatinine (uCr) levels were measured. Results: During the study, all 63 cases (male/female, 13.50) with VUR were included for further evaluation. The mean age of the patients was 59.1 ± 34.7 months (range 2 to 132 months). Twelve subjects suffered from unilateral VUR, while bilateral VUR inflicted 51. According to the disease severity, nine patients had mild, 35 had moderate, and 19 had a severe form of VUR. No significant difference was observed between patients with (n = 31) and without (n = 32) renal scars regarding mean levels of the uNGAL and uNGAL/uCR ratios (P>0.05). Conclusion: We found no significant difference between the groups with and without the renal scar in terms of biomarker levels.
Protective effects of pretreatment or concomitant treatment with Hypericum extract on renal function and renal toxicity in cisplatin-induced nephrotoxicity
Authors: Ghaneialvar Hori , Kaffashian Mohammad Reza , Salimi Amir Hussein , Moulaei Neda , Afsordeh Nastaran , Parvari Shams , Abasi Naser , Kenarkoohi Azra , Maleki Maryam
Published: May 2022

Introduction: Cisplatin is a strong anticancer medicine, but its use is limited due to the potential nephrotoxicity induction. Objectives: The present study seeks to determine the impact of Hypericum hydroalcoholic extract on cisplatin-induced nephrotoxicity. Materials and Methods: Thirty-two male rats were assigned to groups 1 to 4. Group 1, control (Cont); treated by saline (IP). Group 2, Cis; cisplatin [intraperitoneal (IP), 7.5 mg/kg]. Group 3, CisH; cisplatin + Hypericum (70 mg/kg, IP, for one week). Group 4, HCis; first treated with Hypericum for a week, followed by cisplatin. Renal tissue and blood samples were obtained a week after cisplatin injection for tissue assay and biochemical analysis. Kidney tissue damage score (KTDS), plasma creatinine (Cr), blood urea nitrogen (BUN), serum glutamate oxaloacetate transaminase (SGOT), serum glutamate pyruvate transaminase (SGPT), malondialdehyde (MDA), superoxide dismutase (SOD), and catalase (CAT) were measured. Results: Kidney weight showed significant differences between the treated groups and the Cont group (P<0.001). Serum BUN, Cr, SGOT, and SGPT increased significantly in Cont (P<0.01). BUN decreased in CisH and HCis groups compared to Cis group, although there was no significant difference. Serum Cr, SGOT, and SGPT decreased significantly in CisH and HCis groups compared to the Cis group (P<0.05). MDA and KTDS increased in the Cis group and decreased significantly in the CisH and HCis groups compared to the Cis group (P<0.05). Serum SOD and CAT decreased significantly in Cis compared to Cont (P<0.05) and increased in CisH and HCis groups compared to Cis. There was no significant difference between the CisH and HCis groups in any of the measured parameters. Conclusion: This study reveals that pretreatment with Hypericum extract or its concomitant administration with cisplatin can moderate the side-effects of cisplatin, improve renal function and decrease lipid peroxidation, renal toxicity and the KTDS.
IL-17 gene polymorphism (rs763780) in kidney recipients with post-transplant diabetes
Authors: Zununi Vahed Sepideh , Etemadi Jalal , Majidi Taraneh , Hejazian Seyyedeh Mina , Ronaghi Paria , Ardalan Mohammadreza
Published: May 2022

Introduction: New-onset diabetes mellitus after transplantation (NODAT) is a common complication of organ transplantation, leading to allograft dysfunction. Genetic alterations of inflammatory cytokines have been reported to be associated with glucose homeostasis and diabetes. Objectives: This study evaluated the rs763780 polymorphism of IL-17F gene in transplant recipients with and without NODAT. Patients and Methods: The present retrospective study was conducted on ninety-one patients who have had a kidney transplant for at least three months. Patients were divided into two subgroups; recipients with NODAT (n=32) and kidney recipients without NODAT (n=59). After DNA extraction from patients’ blood samples, amplification and evaluation of specific polymorphism of the gene were performed using amplification refractory mutation system-polymerase chain reaction (ARMS-PCR). Clinical and demographic data of patients were collected. Results: The NODAT was detected in 81.3% (n=26) of TT genotype carriers, 12.5% of TC genotype carriers and 6.3% of CC genotype carriers. No statistically significant differences between the studied groups in the frequency of C and T alleles and the distribution of the abovementioned genotypes were detected (P≥0.721). In the NODAT group, graft rejection and age of patients were higher significantly (P≤0.017). Conclusion: No significant correlation between the incidence of diabetes and rs763780 polymorphism of IL-17F gene was observed.
Renal vein thrombosis in a recent COVID-19 patient; a case report
Authors: Mirfakhraee Hosna , Saghafian Larijani Samaneh , Zandieh Zhale , Tizmaghaze Adnan , Olamaeian Faranak , Tayebi Ali , Niksolat Maryam
Published: May 2022

We report a 74-year-old male with a recent history of COVID-19 pneumonia who was admitted with acute periumbilical and left lower quadrant pain and respiratory distress. Laboratory data showed pre-renal azotemia and microscopic hematuria. An abdominopelvic computerized tomography (CT) scan with intravenous contrast was conducted, showing signs of right renal vein thrombosis (RVT) with extension to inferior vena cava (IVC), without any evidence of renal ischemia. The patient did not have any risk factors for thrombosis except for probable hypercoagulopathy due to COVID-19 and diabetes mellitus. He was not an appropriate candidate for surgical or radiologic thrombectomy, thus received heparin infusion accordingly. Unfortunately, he died after the cardiopulmonary arrest on the second day of admission. Considering his respiratory distress, we suspect pulmonary embolism as the most probable cause of death.