Comments on: blood product transfusion in emergency department patients: a case control study of practice patterns and impact on outcome

Clinical decision makings according studies result require the valid and correct data collection, andanalysis. However, there are some common methodological and statistical issues which may ignore by authors. In individual matched case- control design bias arising from the unconditional analysis instead of conditional analysis. Using an unconditional logistic for matched data causes the imposition of a large number of nuisance parameters which may result in seriously biased estimates.     

Comparative study of radioprotective effects of selenium nanoparticles and sodium selenite in irradiation-induced nephropathy of mice model

Purpose: The current study was undertaken to evaluate radioprotective effects of selenium (Se) nanoparticles in irradiation-induced nephropathy of mice model compared to sodium selenite.

Materials and methods: Forty-five mice were divided into three major groups including control, Se nanoparticle, and sodium selenite. Each major group was further subdivided into three more groups receiving various doses of 0, 2, and 8?Gy gamma irradiation. Both of the supplements were administered intraperitoneally with the dose of 0.1?mg/kg for 14 consecutive days. At the end of each week, the animals were exposed to gamma radiation and 48?h after the last exposure, the animals were humanely euthanized, then blood and renal tissue samples were taken. Serum creatinine, urea, cystatin C, and beta-2-microglobulin levels as well as activities of renal antioxidant enzymes, superoxide dismutase, glutathione peroxidase and catalase, also malondialdehyde level, total antioxidant capacity, renal tissue Se content, and histopathological features were assessed.

Results: The results showed that both of the supplements could normalize aforementioned indices. However, selenium nanoparticles (Se-NPs) were more effective than sodium selenite.

Conclusions: Conclusively, Se-NPs as an emerging potent antioxidant agent can protect against irradiation-induced nephropathy.     

Comparison of cryotherapy and curettage for the treatment of pyogenic granuloma: a randomized trial

BACKGROUND: Pyogenic granuloma is a benign vascular lesion of the skin and mucous membranes. Many different treatments have been used, with variable success rates. OBJECTIVES: To evaluate and compare the effects of cryotherapy and curettage in the treatment of pyogenic granuloma. METHODS: Eighty-nine patients with pyogenic granuloma were randomized to receive cryotherapy with liquid nitrogen or curettage and electrodesiccation. Forty patients in the cryotherapy group and 36 patients in the curettage group completed the study period. RESULTS: Among the patients who completed the study, treatment resulted in complete resolution of all lesions after one to three sessions (mean 1.42) in the cryotherapy group and after one to two sessions (mean 1.03) in the curettage group. The difference between the two groups was statistically significant (P < 0.001). Twenty-three patients (57.5%) in the cryotherapy group and 25 patients (69%) in the curettage group had no scar or pigmentation abnormality. Except for cosmetic problems, no other side-effect or complication was recorded in the study. CONCLUSIONS: This study showed that both cryotherapy and curettage are safe and effective. Curettage had the advantage of fewer treatment sessions required to achieve resolution and better cosmetic results. We suggest that curettage could be the first-line treatment for pyogenic granuloma.     

Comparison of ischemic and ischemic/reperfused kidney injury via clamping renal artery,vein, or pedicle in anesthetized rats

International Urology and Nephrology - We recently observed that 30 min of bilateral renal arterial, venous, or pedicle occlusion with 2-h reperfusion differentially induced acute kidney injury...     

WHO quality of life-BREF 26 questionnaire: reliability and validity of the Persian version and compare it with Iranian diabetics quality of life questionnaire in diabetic patients

There are several tools for the assessment of quality of life (QOL) in diabetes mellitus. In the current research, two standard questionnaires for evaluating of QOL were selected. First one was a questionnaire from the World Health Organization quality of life (WHOQOL-BREF 26) and the second one, The Iranian diabetics quality of life (IRDQOL). The first aim of this study was to reliability and validity of the Persian Version of WHOQOL-BREF 26. The second aims compare it with IRDQOL questionnaire in diabetic patients. A random sample of Iranian adult outpatient diabetics (n=387) was selected and they completed the WHOQOL and IRDQOL assessment instruments. In addition HbA1c was measured in these patients by calorimetric method. Data analysis was carried out by the use of T-test, Spearman correlation coefficient, Pearson's correlation coefficient. Data analysis based on Pearson correlations in the two questionnaires showed all subscales and total QOL have highly acceptable test-retest reliability. Comparison of total QOL and similar domains in the two questionnaires showed physical domain score in IRDQOL was lower than in WHOQOL and it was significant (P<.0001). Total QOL is more highly correlated with social domain and environmental domain in IRDQOL and WHOQOL, respectively. In IRDQOL, spiritual domain is not correlated with physical domain. Calculated parameters of reliability in the questionnaires indicated that stability present promising results in total QOL. In this study, WHOQOL domains have a logical relationship between glycemic control and QOL, but this logical relationship cannot be found in IRDQOL questionnaire. In IRDQOL spiritual domain is a very unreliable domain. We recommend more questions to be added spiritual domain in IRDQOL questionnaire and also distribution of items to be some how equal in four domains. By these, it may help to find some rational relations between afore-mentioned domains and glycemic control.     

Polymorphisms in one-carbon metabolism and trans-sulfuration pathway genes and susceptibility to bladder cancer

We have previously reported significant inverse associations between bladder cancer risk and dietary intake of vitamins B2, B6, B12, folate and protein in a hospital-based bladder cancer case-control study conducted in Spain (1,150 cases;1,149 controls). Because these dietary factors are involved in the one-carbon metabolism pathway, we evaluated associations between bladder cancer risk and 33 single nucleotide polymorphisms (SNPs) in 8 genes (CBS, CTH, MTHFR, MTR, MTRR, SHMT1, SLC19A1 and TYMS) and interactions with dietary variables involved in this pathway. Two SNPs in the CTH gene were significantly associated with bladder cancer risk. OR (95% CI) for heterozygous and the homozygous variants compared to homozygous wild-type individuals were: 1.37 (1.04-1.80) IVS3-66 A > C and 1.22 (1.02-1.45) IVS10-430 C > T. Because the CTH gene is important for glutathione synthesis, we examined interactions with the GSTM1 gene, which codes for glutathione S-transferase muu. Increased risk for individuals with the IVS10-430 CT or TT genotype was limited to those with the GSTM1 null genotype (p-interaction = 0.02). No other SNPs were associated with risk of bladder cancer. These findings suggest that common genetic variants in the one-carbon pathway may not play an important role in the etiology of bladder cancer. However, our results provide some evidence that variation in glutathione synthesis may contribute to risk, particularly among individuals who carry a deletion in GSTM1. Additional work is needed to comprehensively evaluate genomic variation in CTH and related genes in the trans-sulfuration pathway and bladder cancer risk.     

Comparison of the clinical usefulness of two quantitative D-Dimer tests in patients with a low clinical probability of pulmonary embolism

Background

Quantitative D-Dimer tests are established methods in the non-invasive diagnostic management to rule out venous thromboembolism (VTE). The diagnostic performance and the clinical efficiency different D-Dimer assays in the exclusion of pulmonary embolism (PE) have not yet been compared in a clinical outcome study.

Objective

Evaluation of the efficiency and safety of excluding the diagnosis of PE with two different quantitative D-Dimer assays in consecutive patients with clinically suspected PE.

Patients and Methods

We studied the VTE-failure rate of 2206 consecutive patients with an unlikely clinical probability in whom VIDAS or Tinaquant D-Dimer tests were performed.

Results

The prevalence of PE in 1238 patients whose D-Dimer level was analyzed with Tinaquant assay was 11%. The VIDAS assay group consisted of 968 patients with a PE prevalence of 13%. The VIDAS assay had a sensitivity of 99.2% (95%CI; 96- > 99.9%), the Tinaquant assay of 97.3% (95%CI; 93 -99%). The negative predictive value (NPV) in the Tinaquant assay group was 99.4% (95%CI 98-99.8%) in comparison to 99.7% (95%CI 99-> 99.9%) in the VIDAS assay group. During 3 month of follow-up, there were no fatal cases of PE among patients with normal D-Dimer and unlikely clinical probability in both D-Dimer assay groups. In addition, the test efficiency of Tinaquant assay was significantly higher in comparison to VIDAS assay (52% vs 42%, p < 0.001).

Conclusion

Both Tinaquant and VIDAS D-Dimer tests perform equally well in combination with an unlikely clinical probability in excluding PE. The Tinaquant test was shown to be more efficient.     

One-stage tract dilation for percutaneous nephrolithotomy: is it justified?

PURPOSE: To assess the feasibility of one-stage acute dilation of the nephrostomy tract with a 30F Amplatz dilator in patients who are candidate for percutaneous nephrolithotomy (PCNL) regardless of whether there is a previous renal scar to make the procedure less time consuming and more cost effective. PATIENTS AND METHODS: The outcomes of one-stage tract dilation for PCNL in 100 consecutive patients with and without a history of ipsilateral open stone surgery (OSS), treated by one surgeon, were examined prospectively. Forty-six patients (group 1) had a history of ipsilateral OSS, and 54 patients (group 2) did not have this history. Demographic data as well as intraoperative information, such as access time and radiation exposure time during access, were recorded. The success of the access technique and its bleeding complications were analyzed between the two groups. RESULTS: By applying a "one-stage" technique, the targeted calix could be entered with a success rate of 93%. There was no difference in the procedural success rate between groups 1 and 2 (93.5% v 92.6%, respectively). All seven failed attempts (7%; three with previous OSS) were managed successfully using an Alken dilator to gain access to the proposed calix in the same session. Previous OSS did not impact access time, radiation exposure time during access, postoperative hemoglobin drop, and bleeding complications. There were no visceral and vascular injuries. CONCLUSIONS: One-stage tract dilation for PCNL is a safe and effective method in almost every adult patient.     

A logistic regression model for predicting health-related quality of life in kidney transplant recipients

BACKGROUND: To develop a logistic regression model capable of predicting health-related quality of life (HRQOL) among kidney transplant recipients and determine its accuracy. METHODS: Three groups of patients were selected: 70 healthy controls, 136 kidney transplant patients as a derivation set, and another 110 kidney transplant patients as a validation set. SF-36 score was used for HRQOL measurement. A cutoff point to define poor versus good HRQOL was calculated using the SF-36 scores of healthy controls. A logistic regression model was used to derive predictive parameters from the derivation set. The derived model was then tested among the validation set. HRQOL predictions made by the model for the patients in the validation set and the SF-36 scores were compared. We calculated sensitivity, specificity, positive and negative predictive values, and model accuracy. RESULTS: SF-36 scores below 58.8 were defined as an indication of poor HRQOL. The regression model suggested that poor HRQOL was positively associated with lower education (below high school diploma), being single or widowed, and diabetes/hypertension as etiology. It was negatively associated with younger age (<45 years) at the time of transplantation. Optimal sensitivity and specificity were achieved at a cutoff value of 0.74 for the estimated probability of poor HRQOL. Sensitivity, specificity, positive and negative predictive values, and accuracy of the model were 73%, 70%, 80%, 60%, and 72%, respectively. CONCLUSION: The suggested model can be used to predict poor posttransplant HRQOL among renal graft recipients using simple variables with acceptable accuracy. This modal can be of use in decision making in the recipients for whom achieving good HRQOL is the main aim of transplantation, to select high-risk patients and to start interventional programs to prevent a poor HRQOL.