Serum triiodothyronine level as an indicator of inflammation in patients undergoing dialysis

INTRODUCTION. It has been shown that inflammation affects thyroid function. In patients with end-stage renal disease, low plasma triiodothyronine (T3) may be an unsuspected expression of the inflammatory state of these patients. This study evaluated the correlation between T3 and high-sensitivity C-reactive protein (HSCRP) levels in patients on peritoneal dialysis (PD) and hemodialysis. MATERIALS AND METHODS. This is a cross-sectional study aiming at the correlation between T3 and HSCRP levels among 30 patients on PD, 30 patients on hemodialysis, and 20 healthy individuals. Serum levels of HSCRP, T3, thyroxine (T4), thyroid stimulating hormone, T3 resin uptake, and free T3 index (FT3I) and free T4 index (FT4I) were compared between the three groups. RESULTS. There were no significant differences between hemodialysis and PD patients in respect to T3, T4, FT3I, and FT4I. In PD and hemodialysis patients, T3 and FT3I were lower than in controls (P < .001), but there was no significant difference between PD and hemodialysis patients. T3 resin uptake and thyroid stimulating hormone differed significantly between PD and hemodialysis patients. There was a significant inverse correlation between HSCRP and T3 and FT3I among hemodialysis patients (P = .04); however, there was no such correlations in PD patients. CONCLUSIONS. The relationship between T3 and HSCRP suggests that inflammation might be involved in the low T3 syndrome in hemodialysis patients, but we did not find a significant correlation between T3 and HSCRP levels in patients on peritoneal dialysis.     

Impact of the Ki-67 proliferation index on response to peptide receptor radionuclide therapy

Purpose

The role of the Ki-67 tumour proliferation index (PI) in predicting the efficacy of peptide receptor radionuclide therapy (PRRT) in gastroenteropancreatic tumours (GEP-NET) remains undetermined. This single-centre analysis focused on the potential therapeutic impact of this immunohistochemical parameter.

Methods

A total of 81 consecutive GEP-NET patients treated with ¹⁷⁷Lu-DOTA-octreotate (mean activity of 7.9?GBq per cycle, usually four treatment cycles at standard intervals of 3?months) were retrospectively analysed. Both an evaluable PI and tumour response (modified SWOG criteria) were required for patient inclusion.

Results

Response of tumours with a PI of ??20% (partial response 40%, minor response 15%, stable disease 34%, progressive disease 11%) was comparable in all PI subsets, including those with a PI of 20%. However, G3 tumours (PI?>?20%) showed progression in 71% of patients.

Conclusion

Response to PRRT is consistent over the PI range of ??20% (G1 + G2). Contrary to preliminary previous suggestions, a PI of 15% or 20% should not preclude candidates from somatostatin receptor-targeted radiotherapy.     

Nitrous oxide/oxygen compared with fentanyl in reducing pain among adults with isolated extremity trauma: A randomized trial

Objective: To compare the effectiveness of nitrous oxide/oxygen (N₂O/O₂) and fentanyl in relieving pain among patients with an isolated long bone fracture or main joint dislocation of the limbs. Methods: Patients with isolated long bone fracture or main joint dislocation with moderate to severe pain were randomized into two groups. For the first group, nitrous oxide/oxygen (50:50) was self‐administered until pain relief was achieved up to a maximum of 15 min. Fentanyl (2 µg/kg) as a single dose was administered for the second group. Pain intensity was measured with a visual analogue scale before and at minutes three, six and nine after the start of the drug administration. We also recorded observed adverse effects in these two groups. Results: One hundred patients were enrolled in the study. No statistically significant difference in pain score was detected between the two groups with one exception. The mean visual analogue scale scores at 9 min were 2.2 and 3.1 for nitrous oxide/oxygen and fentanyl, respectively (difference ?0.9 [95% CI ?1.7–?0.1]) (P= 0.006). There was no statistically significant difference between two groups regarding adverse effects. Conclusions: Neither nitrous oxide/oxygen or fentanyl appeared to be superior to the other in relieving moderate to severe pain among emergency patients presenting with isolated limb fracture or dislocation. In an ED, increased use of nitrous oxide might reduce the overall need for opiate analgesia, and in our setting, the need for constant monitoring.     

Organophosphorous residue in Liza aurata and Cyprinus carpio

Objective

To determine the amount of azinphos methyl and diazinon residues in two river fishes, Liza aurata and Cyprinus carpio, in the north of Iran.

Methods

This study was done during 2006-2007. In this survey, 152 water and fish samples from Gorgan and Qarasu rivers, north of Iran, were investigated. Sampling was done in three predetermined stations along each river. Organophosphorus compounds (OPs) were extracted from the fishes and the water of rivers. After extraction, purification and concentration processes, the amount and type of insecticides in water and fish samples were determined by high performance thin layer chromatography (HPTLC).

Results

There was a significant difference in the residue of the insecticides in the water and fish samples between summer and other seasons in the two rivers. The highest amount of insecticides residue was seen during summer. In both rivers, the amount of diazinon and azinphos methyl residues in the two fishes was more than 2 000 mg/L in summer. There was no significant difference in insecticides residue between the fishes in two rivers. The diazinon residue was higher than the standard limits in both rivers during the spring and the summer, but the residual amount of azinphos methyl was higher than the standard limits only during the summer and only in Qarasu River.

Conclusions

It can be concluded that the amount of OPs in the water and the two fishes, Liza aurata and Cyprinus carpio, is higher than the permitted levels.     

A Sensitive and Specific PCR Based Method for Identification of Cryptosporidium Sp. Using New Primers from 18S Ribosomal RNA

Background

The main goal of the present study was to develop a new sensitive and specific PCR based method for Identification of Cryptosporidium sp. using novel primers from 18S ribosomal RNA. Cryptosporidiosis in high-risk host groups particularly in neonates and immuno-compromised individuals may result in death. To the best of our knowledge this is the first study regarding develop a new PCR based method to diagnose the cryptosporidiosis in Iran.

Methods

A total of 850 human fecal samples from patients clinically suspected to cryptosporidiosis and 100 healthy and diarrheic cattle stool specimens were collected. The simplified formol-ether concentration method was carried out for all samples. They were then examined microscopically by modified Ziehl-Neelsen staining method. Total DNA was extracted by QIA amp DNA stool mini kit. PCR and nested-PCR was carried out by using designed primers.

Results

Twenty nine cases of cryptosporidiosis infection in human and 30 samples from cattle microscopically were positive. The described primary and nested PCR method could detect all Cryptosporidium positive samples from human and cattle. Regards to suspected negative samples in primary PCR examination, the Nested PCR could approve two more positive results. Furthermore, Nested PCR analysis was able to detect one more case which was negative in both microscopically examination and primary PCR. Specificity of the test was 100%. Sensitivity of Nested PCR in comparison to our gold standard; microscopy after Ridley concentration modified ziehl-Neelsen, was 100%.

Conclusion

Our developed PCR based method by using new primers devised from 18S ribosomal RNA revealed the ability for identification of the Cryptosporidium species such as C. parvum and C. huminis with high specificity and sensitivity.     

Investigating Association of Three Polymorphisms of Coagulation Factor XIII and Recurrent Pregnancy Loss

Citation Jeddi‐Tehrani M, Torabi R, Mohammadzadeh A, Arefi S, Keramatipour M, Zeraati H, Zarnani AH, Akhondi MM, Mahmoudian J, Mahmoudi AR, Zarei S. Investigating association of three polymorphisms of coagulation factor XIII and recurrent pregnancy loss. Am J Reprod Immunol 2010; 64: 212–217 Problem Among important suspected causes of thrombophilia in women with recurrent pregnancy loss (RPL) are the polymorphisms of coagulation factor XIII (FXIII) gene. We performed a case–control study on the association between three polymorphisms of factor XIII (FXIII G103T, FXIII A614T and FXIII C1694T) and RPL in Iranian women. Method of study DNA samples from peripheral blood of 100 female patients with at least two recurrent abortions, as case group, and 100 healthy women with history of at least two successful deliveries were subjected to PCR‐RFLP, and the frequencies of the polymorphisms were calculated and compared between the two groups. Results The prevalence of FXIII G103T polymorphism was 29% in the case group and 17% in the control group (P = 0.158). The frequencies of FXIII A614T and FXIII C1694T were 84% and 66% in the case group and 48% and 31% in the control group (P < 0.001 and P < 0.001), respectively. The two latter polymorphisms are associated with RPL in Iranian women and increase the risk of RPL. A correlation was also found between FXIII A614T and FXIII C1694T polymorphisms (P < 0.001). Conclusion We suggest the evaluation of FXIII A614T and FXIII C1694T polymorphisms in women with RPL.     

Quality Assessment of Services in Primary Healthcare in Iran: A Systematic Review and Meta-analysis

BackgroundPrimary healthcare (PHC) plays an important role in achieving universal health coverage (UHC). The SERVQUAL instrument is the tool for evaluating the quality of services in the health sector. The main purpose of this study is to evaluate the quality of services provided in PHC in Iran using the SERVQUAL instrument.Materials and MethodWe searched eight databases from January 2000 to September 2021. We analyzed the mean of various SERVQUAL instrument items using the DerSimonian-Laird approach via a random model with 95% confidence interval. Also, we used I2 to evaluate the heterogeneity of the studies.ResultsFinally, 17 studies were chosen for analysis in the present study. There were 8,767 study participants, out of which 8,237 were female and 530 were male. The mean dimensions of perception were as follows: Tangibles = 3.71, reliability = 4, responsiveness = 3.79, assurance = 3.83, and empathy = 3.86. For the expectation, the mean dimension were: Tangibles = 4.46, reliability = 4.46, responsiveness = 4.36, assurance = 4.36, and empathy = 4.36 respectively. The total gap quality between perception and expectation was -0.53.ConclusionAll dimensions of quality based on SERVQUAL were negative, and the quality of service in PHC is not satisfactory. Therefore, policymakers must adopt serious and effective programs to improve services in this area. We also recommend that quality management of services in PHC in Iran should move toward comprehensive optimization in all areas, and quality in this area should be a priority.