Showing 472 results for SS
Ziaee V, Kordi R, Alizadeh R, Afsharjoo Hr, Yunessian M, Halabchi F ,
Volume 60, Issue 3 (14 2002)
Abstract
Background: To determine the incidence and risk factors of acute mountain sickness (A - AMS) in pilgrims. Although it is well known that western trekkers suffer from acute mountain sickness (AMS) in other mountains, not much is documented about the incidence of AMS in the Damavand Mountains, Iranian population that go to high altitude and its related contributing factors.
Materials and Methods: The design was a cross sectional study. During six weeks (in summer 2000) a population of 459 pilgrims was studied. The period of the study was six weeks in summer AMS symptoms, were assessed by an extensively used standard questionnaier (Lake Louise), applied at 2900 m, after than arrive at 4200 m above sea level, and during descent from summit Damavand (at 4200 m) at Damavand in Iran Alborz Mountain.
Results: The overall incidence of A.M.S. was 60.8 percent. Climbers had 13-71 years and 67.8 percent of the study population was men. Men did not differ significantly higher rate of AMS from women. The incidence being increased in those who residence at an altitude below 600 m, climbed fast, amateur climbers, a previous AMS experience or high altitude illness, a history of AMS at ascent to Damavand and ascent time at night (6pm-6am). It was weakly dependent to rate of ascent (from 2800 m up 4200 m less that 4 hours) and sleep in 4200 m. The incidence of AMS was unrelated to sex, age, body mass index (BMI), height, weight, smoking, to the load carried and knapsack and spent more than 15 hours in shelter (at 4200 m). So it was independent of rate of ascent in the higher altitude (from 4200 m to 5671 m), speed of descent and family history of AMS.
Conclusions: Data show a strong relation between experiences mountaineer, history of AMS, ascent time at night and the incidence of acute mountain sickness in 459 climbers studied at high altitudes that didn’t report previously.
Khatami Z, Roohi S, Nami A, Shakeri N, Abbassi M ,
Volume 60, Issue 6 (15 2002)
Abstract
Introduction: In this study, we reviewuated and compared three routine methods for the measurement of urinary protein concentrations with a view to find a suitable method to prevent, diagnose and monitor renal disease under circumstances with limited resources.
Materials and Methods: Two modifications of the Trichoroacetic acid (TCA) turbidimetric method read at 405 and 620 nm and the sulfosalicylic acid (SSA) turbidimetric method were considered. The reviewuated was carried out using a variety of control materials, calibrators and patients urine samples.
Results: The result indicated that the TCA method read at 405nm is appropriate for the measurement of protein in the range of 25-700 mg/L and the TCA "620nm method" is appropriate for the measurement of protein concentration in the range of 100-1000 mg/L. Of the two methods, the TCA at 405 nm was minimally influenced by the type of calibrator. The SSA method showed unacceptable performance in the measurement of protein, specially at lower concentration, in addition the results showed a large variation depending on the type of calibration.
Conclusion: For screening of high-risk populations e.g. diabetics and early diagnosis of microproteinuria the recommended method is the TCA at 405 nm calibrated with a serum-based mixed Albumin/Globulin standard. For routine testing the TCA method at 620 is suggested regardless of type of calibration, although the limitations at lower concentrations should be remembered.
Rassulinejad M, Hossami Roodsari H, Mahdavi Mazdeh M, Hajiabdolbaghi M, Ahmadi F L,
Volume 61, Issue 6 (15 2003)
Abstract
Renal transplantation is ideal treatment of chronic renal failure. Pulmonary infection is a common and serious post transplant infection requiring hospitalization and is associated with high mortality. Increased susceptibility to infection is due to a decrease in the patients' immunological response caused by immunosuppression through drug administration, and by other influences.
Materials and Methods: This study was case series and prospective, from July 2001 to July 2002 in Imam Khomeini hospital of Tehran.
Results: 164 renal transplant recipients were studied, 14 patients (8.5%) had pulmonary infection, 11 of them (78.6%) were female and 3 (21.4%) were male. The mean age of them was 42.6 years. The patients were followed up for 9 to 12 months. All patients were on triple immunosuppressive regimens. The interval between transplantation and the appearance of pneumonia was 2 months to 10 years. The time of beginning infection in 3 cases (21.4%) was between 1 to 6 months post transplantation, 11 cases (78.6%) were occurred beyond 6 months after transplantation. In 7 cases (50%), pulmonary infection was occurred during first year after transplantation. None of the 14 patients developed pulmonary infection in first month after transplantation. BAL were used in 6 cases (42.8%) of pulmonary infection, and organism were detected in 5 of them (83.3%). The most common clinical feature was fever. Six cases were due to mycobacterium tuberculosis (42.9%), this organism was the most common ethiology of pneumonia. In this study tuberculosis was seen in 3.6% of renal transplant recipients. One patient had pulmonary mucormycosis. All patients with pulmonary TB were cured, and other cases with unknown case, were cured with empirical treatment.
Conclusion: Our finding indicate the invasive diagnostic procedures are required in order to earlier and reliable diagnosis and then better outcome of transplantation.
Khlkhali K, Sadr Hosseini S M, Azizi M R, Dashti Khoidaki Gh A,
Volume 61, Issue 6 (15 2003)
Abstract
Kimura's disease (K.D) is an uncommon, benign, chronic inflammatory condition of unknown etiology and pathogenesis involving subcutaneous tissue presenting as a tumor like lesion with a predilection for the head and neck region. If parotid gland is affected clinically it is often confused with parotid tumor with lymph node metastasis. It is difficult to diagnosis before tissue biopsy and fine middle aspiration (FNA) has only limited value. There is no evidence of malignant transformation and occasional spontaneous resolution occurs. Various treatment modalities have been suggested in the management of this condition but none is proved best and recurrence is common. we describe a 33 - year- old man with KD who presented with left parotid mass.
Fahimi D, Khosroshahi N, Al Hossein S M, Amin Nejad M, Ansari M,
Volume 61, Issue 6 (15 2003)
Abstract
Acute Pyelonephritis (APN) is one of the most common bacterial infections seen in children that may lead to renal scarring. Vesicoureteral reflux (VUR) is an important risk factor of renal damage but not the only one.
Materials and Methods: In order to determine the association between dimercaptosuccinic acid (DMSA) scintigraphic and voiding cystourethrographic findings, a retrospective study was performed on 50 children (100 renal units) with APN that had been admitted to Bahrami Hospital from 1995 through 1998. Voiding cystourethrography (VCUG) and DMSA scan were performed in all patients within 1 to 2 weeks after termination of treatment and a second scan was performed 6 months later in patients whose kidneys showed cortical defects in the first one. The grade of reflux was based on international reflux classification (I-V). The DMSA scans were considered abnormal if one or more areas of decreased cortical uptake were noted (cortical defect). The scar was defined as persistence of these defects in the second scan. DMSA cortical defect and VUR were demonstrated in 42 (42%) and 26 (26%) of renal units respectively.
Results: Fourteen out of 26 renal units (54%) with reflux had cortical defects and 28 out of 74 renal units (38%) without reflux had cortical defects (P=0.15). Permanent renal scarring was noted in 25/ 42 of renal units (62 %) in second scan.
Conclusion: It seems that VCUG alone is insufficient as a screening modality to identity those kidneys at risk of damage and DMSA scan may provide additional information about this.
Fooladsaz K, Ansari M, Javad Rassaie M,
Volume 62, Issue 1 (12 2004)
Abstract
Background: Migraine is a chronic hereditary and relapsing headache. With regard to the prevalence of this ancient disease and its economic complications in country, in this study , nocturnal serum melatonin of migraine patients and control subjects have been evaluated and compared by ELISA kit.
Materials and Methods: Fifty migraine patients (mostly women) were compared to a control group (mostly men) matched according to age.
Results: Statistical analysis revealed a decrease in nocturnal serum melatonin levels for migraine patients (32.9 28.4) compared to the control one (75.6 56.8). With using of t-test by ELISA kit showed significant difference (p=0.0064).
Conclusion: With regard to this, the pineal gland has the main role in the synchronization of the organism with the environmental conditions and migrainous headaches.
Broojerdi M, Reissie F,
Volume 62, Issue 3 (11 2004)
Abstract
Background: Depression is a common problem and reduces function of persons. Evaluation of this matter in Gifted Intelligence– because superior their beneficial ness– have more importance. Our aim in this study is to determine relative frequency of depression in Gifted Intelligence as compared with Normal persons.
Materials and Methods: In the context of a case – control study 90 Normal volunteers and 56 very superior volunteers – aged between 20 and 30 years, so that matched in respect of gender – were investigated by Beck Depression Inventory. IQ identification was performed by both Wechsler Adult Intelligence scaling and Ravens progressive Matrices.
Results: out of 90 Normal persons, 36 were depressed (40%) and among 56 Gifted Intelligence, 35 were depressed. (62.5%) In other words relative frequency of depression in Gifted Intelligence– with significant differences– is more.(P<0.05).
Conclusion: Although Gifted Intelligence have more ability in opposition to stress- because higher level of IQ-but in this study was observed that prevalence of depression in Gifted Intelligence is more. This finding may be by reason of higher perception of them and the result of it– actually– more meeting of stress.
F Ghaem Maghami , F Ensani , N Behtash , S E Hosseini Nejad ,
Volume 62, Issue 4 (11 2004)
Abstract
Background: The aim of this investigation is to evaluate the histologic results of biopsy in women with atypical squamous cells of undetermined significance (ASCUS) cytologic diagnosis.
Materials and Methods: We reviewed a series of cases with ASCUS pap smears from March 1999 to Feb 2002 in Imam Khomeini Hospital (n= 104), Who had cervical biopsy indirected colposcopy (103) and in Onec endocervical biopsy obtained without colposcopy. In 60 patients before colposcopy and biopsy repeat pap smear was tabled.
Results: Biopsy revealed 28.8% SIL (14 LSIL and 16 HSIL), 1 invasive carcinoma and 1 endometrial carcinoma. Pap smear repeated for 60 women before colposcopy examination, which 7 (11.7%) of them were normal. ASCUS persisted in 45 cases (75%) and 8 cases (13.3%) turned out to be SIL (6 LSIL, 2 HSIL) of 7 normal repeat smear, 2 marked as LSIL by biopsy. In colposcopic examination 22 of 103 (21.4%) had normal view which one of them was LSIL histologically.
Conclusion: Based on these findings, it seems immediate colposcopy and directed biopsy are appropriate procedures for management of ASCUS and to detect underlying SIL.
Ataei N, Madani A, A Hossain,
Volume 63, Issue 3 (12 2005)
Abstract
Background: Despite several years of intensive investigation, relatively few studies have been made of children with lupus nephritis. The prognosis of children with lupus nephritis is poor for those with diffuse proliferative glomerulonephritis and active interstitial inflammation. As newer treatment modalities become available for patients with severe lupus nephritis, it become increasingly important to identify patients at risk for renal failure. The aim of this study was to evaluate the clinical course, histopathology, serologic features and prognostic significance of some parameters, to identify the risk factors for renal failure and mortality in children with lupus nephritis.
Materials and Methods: Retrospectively 30 children under 16 years of age with lupus nephritis from 1989 to 1999 were studied. All patients received renal biopsy and follow-up biopsies were performed in 3 children. Lupus nephritis was classified by the World Health Organization (WHO) criteria. The clinical and serologic parameters at the time of renal biopsy were recorded.
Results: All children underwent renal biopsy within 1 year of disease onset. There were 1 (3.3%) patients with class II, 5 (16.7%) with class III, 21 (%70) with class IV, and 3 (%10) with class V nephritis based on initial biopsy according to the WHO classification. The mean follow-up time was 60 months. Follow-up biopsies were histologically stationary in 2 patients and progressive in one. The overall renal and patient 5- year survival rates were 46.66% (14/30) and 93.33 %( 2/30) respectively. They were 47.61% (10/21) and 95.21 %( 20/21), respectively, of patients with class IV proliferative glomerulonephritis. Children with renal pathology (class V in the WHO classification system) at initial biopsy, were at high risk for renal failure 66.66% (2/3) or morality %33.33 (1/3) despite aggressive treatment. The results revealed that those with persistent hypertension, anemia, and decreased creatinine clearance rate, nephrotic proteinuria, at initial biopsy were more prone to develop renal failure (P<0.01).
Conclusion: The prognosis of children with class IV nephritis in our study was better than reported in other series in recent years. However, those with class V disease, persistent hypertension, anemia, low creatinine clearance and nephrotic proteinuria at the time of diagnosis are at increased risk for renal failure. The improved results may be due to initial histological classification, better supportive care and selective use of aggressive therapy such as methylprednisolone pulse therapy and intravenous cyclophosphamide for those with high risk factors.
Sh Rhezaii, A.m Hosseini , M Fallahi,
Volume 64, Issue 1 (30 2006)
Abstract
Background and Aim: Today, work related stress has become a common and costly problem in work places that most of studies in the last 30 decades have engaged in this problem. Several reports indicate that the occupations such as nursing which have high psychological job demands and low decision latitude are very stressful. This stress can cause harmful physical and psychological effects on nurses’ health. On the other hand, job stress may result in high rates of injury, tardiness and absenteeism at work place and reduced productivity and organizational commitment leading to low quality of nursing care. Numerous studies suggested that learning new activities and skills such as communication skills is one of the best strategies against job stress .The purpose of this study was to test the effectiveness of communication Skills training in reducing work stress level among nursing personnel in rehabilitation centers.
Materials and Methods: The quasi- experimental design was conducted. A sample of 48 nursing personnel participated in the study. Subjects were randomly assigned to one of two experimental or control groups. Subjects in experimental group participated in a 7- hour’s workshop, all subjects were pre and post tested (one month later) for job stress and communication skills with the Karasek’s Job Content Questionnaire (JCQ) and communication skills test.
Results: Results revealed the following: (1) subjects in both groups after pretest were the middle level of stress and communication skills. (2) After training the experimental group scored higher on the rating of communication skills than control group and had successfully maintained their improvements for 4 weeks. (3) After training the experimental group showed lower level of stress than control group and had successfully maintained their improvements for 4 weeks.
Conclusion: As a result of this research communication skills training could reduce level of stress among nursing personnel, thus. It is recommended to apply communication skills training programs for nursing personnel working at rehabilitation centers in order to assist them to coping with their job stress and improve the quality of nursing care.
P Ayatollahi, S Nafissi, M Eshraghian , A Tarazi,
Volume 64, Issue 1 (30 2006)
Abstract
Background and Aim: Measuring the outcome of chronic diseases such as multiple sclerosis is an important factor in assessment of disease impact on different dimensions of quality of life and in evaluation of therapeutic interventions. The aim of this study was to perform the cross-cultural adaptation of the MSIS-29 which is a MS-specific outcome measure for Iranian patients.
Materials and Methods: The Iranian adaptation process of the MSIS-29 included 5 steps. To evaluate psychometric properties of the translated version, the questionnaire was administered to a consecutive sample of 96 patients with clinically definite MS referred to our out-patient clinic. Test-retest reliability was assessed in a sub-sample consisted of 30 patients. These patients completed the questionnaire on two occasions separated by a 7-day interval. The Iranian version of the SF-36 was also administered to this sub-sample in order to evaluate the validity of translated MSIS-29.
Results: Statistical analysis indicated that the Persian version of the MSIS-29 had high internal consistency (cronbach’s alpha coefficients > 0.70) and test-retest reliability (intra-class correlation coefficients >0.70) and a good validity.
Conclusion: The Persian version of the MSIS-29 is a reliable and valid instrument for measuring MS outcome in Iranian patients. It can be used in clinical trials and cross-sectional studies.
H. Zahedi, V. Akhyani, Z. Hussain Khan, M. Yunesian,
Volume 64, Issue 3 (1 2006)
Abstract
Background: Hyperglycemia is a metabolic response to surgical stress. In this study, patients’ blood glucose changes were measured before, during and after elective eye surgeries under general anesthesia, with two methods: glucometer and glucose oxidase enzyme lab assay. Probable influencing factors and the correlation rate of these two methods were evaluated.
Methods: This analytic cross – sectional original study was performed on 230 American Society of Anesthesiologists (ASA) Class 1or 2 non–diabetic patients. All the patients underwent a similar general anesthesia and their blood glucose levels were measured simultaneously with two cited methods on three occasions.
Results: In all cases, post-surgery blood glucose in comparison to pre-surgery levels increased significantly in both methods irrespective of independent variables of the study. Considering these independent variables, increase in blood glucose levels was significant in most of the patients. The mean increase in blood glucose post-surgery in comparison to pre–surgery, measured with lab assay, had significant statistical correlation with the type of eye surgery but not with other variables like age, gender and duration of surgery. Correlation of the two methods were also partially significant statistically.
Conclusion: Considering the results of this study and the fact that blood glucose changes under general anesthesia is usually unrecognized clinically, we recommend blood glucose measurement in non–diabetic patients during long surgeries. It is advantageous to use Accu–chek (Sensor model) glucometer for this purpose.
M. Adel Ghahraman, F. Hajiabolhassan, M. Naraghi, M. Sedaei, E. Entezari, M. Haddadi Avval, P. Kamali,
Volume 64, Issue 3 (1 2006)
Abstract
Background: The purpose of this study was to identify variables affecting outcome in patients with benign paroxysmal positional vertigo (BPPV) treated with canalith repositioning maneuver (CRM).
Methods: This interventional study was conducted on 58 patients (14 males, 44 females, mean age 48.12+13.22) referred to the Vertigo Rehabilitation Clinic of the Rehabilitation School of Tehran University of Medical Sciences from 2002 to 2004. All patients were treated with CRM. According to the treatment efficacy the patients were allocated in three groups: completely treated, partially treated, and not treated. The effect of factors including age, sex, etiology, duration of BPPV, unilateral or bilateral disease, number of maneuvers, and number of sessions on outcome in patients was evaluated.
Results: Forty-nine patients (84.5%) were completely cured. Age, sex, etiology, and duration did not significantly affect the treatment outcome. Unilateral BPPV can be treated significantly better than bilateral BPPV. Forty-seven patients who were completely treated needed 1 session and thirty-seven of them required 2 maneuvers.
Conclusion: CRM is significantly effective for BPPV treatment. Treating unilateral BPPV is expected to be easier. As most of the patients will be cured by 1 or 2 maneuvers or in 1 session, patients who required more sessions or more maneuvers may not be completely treated.
M. Hozoori, S.a. Keshavarz, M. Hosseini, Sh. Farajzade, A.a. Sabour, H. Sadrzadeh,
Volume 64, Issue 4 (1 2006)
Abstract
Background: The aim of this study was to determine the effect of two different regimes, containing different carbohydrate to protein ratios on performance, serum glucose and insulin after exercise in soccer players in Tehran Iran.
Methods: Nineteen male soccer players under training [age = 17/5 +/- 1.5 (SE) yr] were selected and completed two sequential trials separated by 1 week, in a paired cross-over study design. In each trial, subjects after running to fatigue received one of three regimes, using a random- order design as follows: HPRO ( CHO 56%, PRO 19% & fat 25% of total energy) HCHO ( CHO 64%, PRO 11% & fat 25% of total energy) or control ( CHO 60%, PRO 15% & fat 25% of total energy). The calorie of 3 regimes were equal. After consumption of meal up to120 min, blood was obtained before and at intervals. After 3 hours athlete performance was measured.
Results: The study indicates no significant difference in the serum insulin and glucose response among three regimes (P > 0.05). There was no difference in performance between three regimes after 3 h (p > 0.05).
Conclusion: The results suggest that post exercise regimes have no influence on performance, serum glucose and serum insulin. Thus total energy content and carbohydrate content may be important in recovery after exercise.
Kassra Karvandian, Afshin Jafarzadeh, Asgar Hagipur,
Volume 64, Issue 6 (3 2006)
Abstract
Background: percutaneous dilatational tracheostomy was invented by ciaglia in 1985. With advent of various instruments, various methods such as Fantoni, Grigges and etc, it became a widesepreadly used method of tracheostomy, especially in intensive care unit wards. In our country this was began in 2005, along with many work shops conducted by anesthesiology department of Tehran University of Medical sciences, with help of specialist from Turin University from ITALY.
Case report: In this report two patients who underwent percutaneous dilatational tracheostomy are presented, and are compared with patients who had undergo surgical tracheostomy. Their long and short term complications such as bleeding, injury extents, and recovery was studied and presented.
Conclusion: Tracheostomy is an opening in front of neck, in to the trachea, through which breathing is made possible. Percutaneous Dilatational Ttracheostomy (PDT) is a method of tracheostomy, in which the need for surgery and transfer of patient to operation room is alleviated. Dispite various benefits, PDT has a few short term and long term drawbacks, which are cartilage fracture, injury to vital structures, perforation of posterior wall, sever bleeding displacement of tube, tracheo-esophageal fistula and trache-oinnominate fistula. Incidence of these complications are lower than surgical tracheostomy. Global reports, especialllly from countries with large scale experiences present a different statistic regarding its success as an alternative method for patients with long surveillance and under mechanical ventilation.
Nabavi Sm, Poorfarzam Sh, Ghassemi H,
Volume 64, Issue 7 (9 2006)
Abstract
Background: Multiples sclerosis is a common demyelinating disease of CNS and the main cause of disability in young adults all over the world so any research in different aspects of the disease has great value. researches in Iran are few in quantity and low in sample size. To determine clinical course and prognosis of the disease in Iranian MS patients we have studied these items in a considerable sample size.
Methods: Two hundred and three definite MS patients (according to MC’donalds 2001 criteria) included in this study and a planned questionnaire completed by visiting the patients or by degree of disability estimated according to EDSS (Expanded Disability Status Scale) score system. The results analyzed with SPSS software.
Results: Mean age of the patients was 35. All required examinations have been done by a neurologist and 60.6 percent were female. Mean duration of disease was 8.3 years. the main form of onset of symptoms was sensorimotor (mixed). Mean Attack rate was 5.5 times during the disease duration. Clinical course in 72.4 percent was relapsing-remitting type. Mean disability scale number according to EDSS was 5.2. Death rate was two percent. 69.3 percent of patients were able to work in the society. The degree of disability increased with increasing age, in lower educational state, in longer duration of the disease and in male gender.
Conclusion: The results of clinical course and type of MS, mean of disease duration from the onset and mean EDSS are compatible and comparable with similar studies in other countries though some results are different. For future large sample, multicenter studies recommended
Zamani T.r Sh, Zavaran Hosseini A, Mesbah Namin S.a,
Volume 64, Issue 9 (1 2006)
Abstract
Background: The objective of this study was to investigate the relationship between glucose-6-phosphate dehydrogenase inhibition in macrophages treated with 6-Aminonicotinamide, the amount of nitric oxide (NO) production and the resistance of infected macrophages against Leishmania major infection.
Methods: Peritoneal macrophages of BALB/c mice were isolated and treated with different concentrations (1.25, 2.5, 5, 10 mM) of 6-aminonicotinamide. After 24 hours, the viability of treated macrophages was measured by MTT assay at 540 nm. G6PD activity was measured in the cell extracts 24 hours later. Macrophages were then infected with leishmanial amastigotes and after 18 hours NO production was determined using Griess-reagent. In order to study the inhibition of macrophage activity, 5 mM concentration of 6-AN was used and number of leishmanial amastigotes was recorded in these cells from day 1 to7.
Results: Different concentrations of 6-AN were shown to cause a significant increase in cell death and decrease in G6PD activity and NO production in macrophages. Also, the number of amastigotes in macrophages was increased significantly (p < 0.05).
Conclusion: The concentration of 6-aminonicotinamide and G6PD activity affect the viability of BALB/c mice peritoneal macrophages through production of NO. Inhibition of G6PD activity leads to decreased leishmani-cidal activity of mouse peritoneal macrophages.
Razeghi E, Lessan Pezeshki M, Aazaripour A,
Volume 64, Issue 9 (1 2006)
Abstract
Background: The prognosis of chronic dialysis patients is poor, in part due to the high incidence of cardiovascular disease and malnutrition. It has been recognized that 30-50% of hemodialysis patients have serological evidence of an activated inflammatory response. Chronic inflammation may cause malnutrition and progressive atherosclerotic cardiovascular disease. It would be obvious interest to study prevalence of inflammatory factors particularly CRP as prominent components of inflammatory syndrome in dialysis patients.
The objective of this study was to study prevalence of inflammatory factors particularly C-reactive protein (CRP) in hemodialysis patients.
Methods: We studied 125 dialysis patients in a cross sectional study during summer of 2001 in two university hospitals. Serum CRP (agglutination method), albumin (bromocresol green method) and ferritin (ELISA) were measured in all patients.
Results: One hundred and twenty five patients including 53 (44.1%) men and 72 (55.9%) women were enrolled in this study. Fourteen patients (11.2%) had hypoalbuminemia, 81 (64.8%) had high serum ferritin, and 57 subjects (45.6%) were CRP positive.
Conclusion: According to high prevalence of inflammatory factors especially C-reactive protein in dialysis patients, CRP and other inflammatory factors should be screened in this group of patients routinely because of their prognostic importance.
Assadi F , Akbari Asbagh P, Hajizadeh N,
Volume 64, Issue 10 (2 2006)
Abstract
Background: Microalbuminuria (MA) is associated with increased cardiovascular risk in hypertensive patients, but not many studies have specifically examined the effects of MA-lowering on regression of left ventricular hypertrophy (LVH) among pediatric patients with hypertension.
Methods: Fifty-five patients with essential hypertension, 11 to 19 years old were prospectively studied. All patients received concomitant therapy of hydrochlorothiazide and angiotensin-converting-enzyme inhibitor. Five patients also required angiotensin-receptor blocker to achieve the blood pressure goal. Baseline and 12-month follow-up measures of left ventricular mass index (LVMI) determined by echocardiography and urine microalbumin/creatinine ratio (MA/Cr) were collected. MA was defined as MA/Cr>30. LVH was defined as LVMI>38.6 g/m2. The primary end points were 25% or more reductions in MA and the LVMI.
Results: Weight (r=0.83), body surface area (r=0.85), body mass index (BMI) (r=0.86), systolic blood pressure (SBP) (r=0.57), diastolic blood pressure (DBP) (r=0.49), mean arterial pressure (r=0.53) and MA (r=0.87) were all univariate correlates of LVMI. In a multiple regression analysis, MA, BMI and SBP were significant correlates of LVMI. MA alone explained 76% of the variance of LVMI, whereas BMI and SBP explained only 1.6% and 0.4% of the variance, respectively. MA was the most significant correlate of follow-up LVMI after BMI and SBP were included in the overall multiple regression models.
Conclusion: MA is a strong predictor of LVH in hypertensive children and adolescents. MA-lowering halts the progression of LVH or induces its regression.
Abdi S, Khalessi Mh, Naderpour M,
Volume 64, Issue 10 (2 2006)
Abstract
Background: The objective of this study was to describe the audiologic and related characteristics of a group patient with speech perception affected out of proportion to pure tone hearing loss. A case series of patient were referred for evaluation and management to the Hearing Research Center.To describe the clinical picture of the patients with the key clinical feature of hearing loss for pure tones and reduction in speech discrimination out of proportion to the pure tone loss, having some of the criteria of auditory neuropathy (i.e. normal otoacoustic emissions, OAE, and abnormal auditory brainstem evoked potentials, ABR) and lacking others (e.g. present auditory reflexes).
Methods: Hearing abilities were measured by Pure Tone Audiometry (PTA) and Speech Discrimination Scores (SDS)), measured in all patients using a standardized list of 25 monosyllabic Farsi words at MCL in quiet. Auditory pathway integrity was measured by using Auditory Brainstem Response (ABR) and Otoacoustic Emission (OAE) and anatomical lesions Computed Tomography Scan (CT) and Magnetic Resonance Image (MRI) of brain and retrocochlea. Patient included in the series were 35 patients who have SDS disproportionably low with regard to PTA, absent ABR waves and normal OAE.
Results: All patients reported the beginning of their problem around adolescence. Neither of them had anatomical lesion in imaging studies and neither of them had any finding suggestive of conductive hearing lesion. Although in most of the cases the hearing loss had been more apparent in the lower frequencies (i.e. 1000 Hz and less), a stronger correlation was found between SDS and hearing threshold at higher frequencies. These patients may not benefit from hearing aids, as the outer hair cells are functional and amplification doesn’t seem to help though, it was tried for all.
Conclusion: These patients share a pattern of sensory –neural loss with no detectable lesion. The age of onset and the gradual deterioration are remarkable. It seems that this is a new category of sensory –neural haring loss which deserves more attention.
