Iranian Journal of

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Background: Kidney transplantation is one of the major progresses of medical science with many ethical debates. The shortage of organs and the increases in waiting list for cadaver transplantation has leaded to transplantation from living donors. In this article, we discuss the ethics of transplantation from living kidney donors.
Methods: For compiling this article, we searched in Pubmed and Ovid by the keywords of kidney transplantation, living donor, ethics.
Results: At the first, the history and statistics of kidney transplantation in Iran and other countries are reviewed. We discussed the living kidney transplantation regarding to principles of nonmaleficence, autonomy and justice. The ethical issues of different groups of living donors and the proponents and opponents opinions are expressed. Because of the importance of unrelated living donors, this group is discussed more briefly.
Conclusion: It is realistic to consider the living kidney transplantation as the last option. Arranging a legal and social organization to control the monetary relationship of the recipients and donors and to determine the preferences of kidney receipt in waiting list is reasonable. It is essential to increase the cadaver transplantation resources to decrease the need of kidney transplantation from living donors.

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Background: Nowadays, many progresses have been occurred in medical science and transplantation process. Transplantation is now a life- saving standard treatment for some end stage diseases. Although the organs from brain death donors, are the best resource for cadaverous transplantation, there are many controversies among physicians about it's definition. The other important issue in transplantation is disparity between the supply and demand of organs. Because of the increasing demand for cadaverous organs it is necessary to use some new methods to fascilitate the availability of these resources. What is noteworthy is that each of these methods has some essential ethical issues that should be observed. Surely regarding these issues would prevent the future harms to human being and society.
Methods: For compiling the article, we searched in pubmed and ovid databases for keywords of cadaverous transplantation, brain death, medical ethics, informed consent.
Results: In this article, after a review of transplantation statistics in Iran and other countries we presented a definition for brain death and some methods to expand donor pools. Then ethical views in brain death and informed consent process for cadaverous organs transplantation was discussed.
Conclusion: In using cadaverous organs for transplantation, informed consent and respect to autonomy are very important. All people in the society are authorized to accept or refuse organ donation after their death and , physicians can only encourage and support them.

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Background: Vitamin D deficiency is associated with impaired insulin secretion, glucose intolerance and type 2 diabetes. This study was conducted to investigate the effects of supplementation with 50,000 IU vitamin D on improving serum vitamin D levels and insulin resistance in vitamin D insufficient or deficient type 2 diabetic patients. Methods: In this double blind randomized clinical trial, 81 type 2 diabetic patients with vitamin D levels between 10-30 ng/ml were randomly assigned to intervention (50,000 IU vitamin D3 once a week) and control (placebo once a week) groups according to gender. The study duration was 8 weeks. At the beginning and the end of study, blood samples were collected after 12 hours overnight fasting and fasting serum glucose, insulin and 25-hydroxyvitamin D were measured. Insulin resistance was obtained by HOMA-IR calculation. Results: After 8 weeks supplementation with vitamin D, 25-hydroxyvitamin D level was significantly increased and reached to normal levels in the intervention group. Fasting serum glucose and insulin concentrations and HOMA-IR were significantly decreased in the vitamin D group, but there were no significant changes in the placebo group. Conclusion: Supplementation with 50,000 IU vitamin D for 8 weeks compared to placebo can improve inadequate levels of vitamin D and glycemic indicators in vitamin D insufficient or deficient type 2 diabetic patients.

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Background: There is increasing interest about the relationship between metabolism, obesity and function of thyroid hormones in recent decades. This study aimed to determine the validity of a “thyroid and metabolism questionnaire” and its relationship with metabolism status and function of thyroid hormones. Methods: It was a descriptive cross-sectional study on 164 people aged 20-64 years who were selected randomly from nutrition clinic. “Thyroid and Metabolism questionnaire” including 25 questions were completed for everyone. Biochemical parameters including serum level of T3, T4 and TSH were measured. Resting energy expenditure [REE] was measured by indirect calorimeter. Results: The mean measured REE and calculated with Harris-Benedict formula were 1826.7 ± 475.34 and 2277.6 ± 454.54 kcal in men and 1410.8 ± 205.5 and 1670.73 ± 136.10 kcal in women respectively. The final score of this questionnaire had no significant association with measured REE. REE showed indirect relationship with serum level of T3, T4, T3/T4 and inverse relationship with TSH. Metabolism status of every participant was obtained via measuring and calculating REE with set and formula. The metabolism status of participants showed no agreements with metabolism status that predicted from “Thyroid and Metabolism” questionnaire. There was no significant association between metabolism status that was measured by indirect calorimeter and calculated from “Thyroid and Metabolism” questionnaire. From 25 questions of this questionnaire, only questions number 1, 4, 16 and 23 showed significant association with measured REE [P< 0.05]. Conclusion: Results of this study showed that “Thyroid and Metabolism” questionnaire had internal consistency, but not validity.