Pattern of in-hospital pediatric mortality over a 3-year period at University teaching hospitals in Iran

Introduction:

Causes of death are different and very important for policy makers in different regions. This study was designed to analyze the data for our in-patient children mortality.

Materials and Methods:

In this cross-sectional study from March 2011 to March 2013, all patients from 2 months to 18 years who died in pediatric intensive care unit, emergency room or medical pediatric wards in the teaching hospitals were studied.

Results:

From a total of 18,915 admissions during a 2-year-period, 256 deaths occurred with a mean age of 4.3 ± 5 years and mortality 1.35%. An underlying disease was present in 70.7% of the patients and in 88.5% of them the leading causes of death were related to the underlying diseases. The most common underlying diseases were congenital heart disease and cardiomyopathy in 50 (27.6%). The four main causes of deaths were sepsis (14.8%), pneumonia (14.5%), congestive heart failure (9.8%), and hepatic encephalopathy (9.8%).

Conclusion:

We may conclude that after sepsis and pneumonia, congestive heart failure, and hepatic encephalopathy are the leading causes of death. Most patients who died had underlying diseases including malignancies, heart and liver diseases as the most common causes.     

Role of peroxisome proliferator-activated receptor β agonist on angiogenesis in hindlimb ischemic diabetic rats

IntroductionStudies indicated that PPARβ agonists play a role in modulation of angiogenesis. In this study, we evaluated the effect of specific PPARβ agonist, GW0742, on angiogenesis and serum vascular endothelial growth factor (VEGF), VEGF receptor-2 (VEGFR-2), and nitrite concentrations in hindlimb ischemia in normal and diabetic rats.MethodsHindlimb ischemic rats were divided into four groups: control, diabetic, control, and diabetic treated with GW0742 (n = 7 each). Diabetes was induced by injection of streptozotocin (55 mg/kg, ip). GW0742 was injected 1 day after surgery (1 mg/kg, sc). After 21 days, blood samples were taken, and gastrocnemius muscles were harvested for immunohistochemistry.ResultsGW0742 significantly increased serum nitrite and VEGFR-2 concentrations and VEGF-to-VEGFR-2 ratio in control and diabetic rats. Capillary density was lower in diabetic animals compared to the control, and GW0742 significantly restored the capillary density in the control and diabetic hindlimb ischemic rats.ConclusionPPARβ agonists restore skeletal muscle angiogenesis and can be considered for prevention and/or treatment of peripheral vascular complications in diabetic subjects.     

Design of a gold nanoprobe for the detection of Pseudomonas aeruginosa elastase gene (lasB)

Nosocomial infections are one of the major health problems that increase mortality. Pseudomonas aeruginosa is one of the important causes of nosocomial infections. This bacterium has a gene called the lasB gene, the product of which is a zinc-dependent metalloprotease. This gene plays a central role in the pathogenesis of Pseudomonas spp. This pathogen is highly toxic and destroys tissues and also has a moderating effect on the immune system; on the other hand, it initiates the intracellular pathway of biofilm growth. Although there are methods such as molecular methods for identifying the lasB gene, due to the high cost and the need for specialized personnel, it is necessary to replace them with an appropriate method. In this study, a gold nanoparticle-based DNA diagnostic sensor sensitive to the aggregation states of gold nanoparticles was used to identify amplified and non-amplified lasB genes. The results of the experiment were evaluated both visually and spectrally. The minimum detection value of this method was 10 ng of the amplified lasB gene and 50 ng of the non-amplified lasB gene. This method is very fast, simple, easy and low cost.

In this study, a gold nanoparticle-based DNA diagnostic sensor that is sensitive to the aggregation states of gold nanoparticles was used to identify the amplified and non-amplified lasB gene.     

Comparison of Health Status and Quality of Life of Related Versus Paid Unrelated Living Kidney Donors

The aim of this cross‐sectional study was to assess the health status and quality of life (QOL) of paid unrelated versus related living kidney donors postdonation at Shiraz Transplant Center in Iran. We invited all donors (n = 580, 347 paid unrelated, 233 related) who underwent donor nephrectomy at our center from 2004 to 2010 to participate in a health survey and physical examination. Of 580 donors, 144 consented to participate; participation of paid unrelated donors was significantly lower than related (52/347 vs. 92/233; p < 0.001). Participants underwent a complete physical examination, QOL assessment (using a 36‐item short form health survey [SF‐36] questionnaire) and laboratory work‐up. The paid unrelated donors compared with related donors were younger (34.2 ± 7.2 vs. 40.7 ± 9.7 years, p < 0.001), had shorter time since donation (2.9 ± 1.6 vs. 3.8 ± 2 years, p = 0.004), had higher estimated GFR (72.6 ± 22 vs. 63.8 ± 15.3 mL/min/1.73 m², p = 0.006) and had a higher percentage of patients with microalbuminuria (35% vs. 0%, p < 0.001). Additionally, general health and social functioning scores among paid unrelated donors were significantly lower (p < 0.001 and p = 0.02, respectively) than related donors. Other SF‐36 scores, although lower in paid unrelated donors, did not reach statistical significance. Iranian paid unrelated donors have lower QOL and higher incidence of microalbuminuria compared with related donors.     

Exercise test in pediatric renal transplant recipients and its relationship with their cardiac function

Pediatric kidney transplant recipients are at increased risk of CVD. Exercise test is a good method to evaluate exercise capacity, cardiorespiratory fitness, and risk of potential CVDs. The aim of this study was to assess the exercise capacity in this population and determine its relationship with their cardiac function using conventional and tissue Doppler echocardiography. Exercise test, conventional and tissue Doppler echocardiography were performed on 44 kidney transplant children (age ranging 11–20, 59% male) with acceptable renal function, and the results were compared with their normal healthy counterparts. Our transplant patients achieved significantly lower maximal heart rate, maximal heart rate ratio, total energy expenditure during the exercise, and maximal O₂ consumption (Max VO₂) than the normal group (p < 0.05). No correlation was found between hemoglobin (Hb) level, dialysis duration, kidney function, and the exercise test parameters. Kidney transplant patients had preserved systolic despite diminished diastolic cardiac function compared to the normal children. Our pediatric renal transplant recipients had severely impaired diastolic dysfunction and significantly reduced MaxVO₂ compared with their healthy counterparts. No correlation was found between MaxVO₂ and measured indices of systolic and diastolic cardiac function.     

Bone and joint complications related to Gaucher disease

There is a broad spectrum of Gaucher disease-related skeletal complications, ranging from asymptomatic osteopenia to osteonecrosis (of the shoulders and hips) with secondary degenerative joint disease. Characterization of the pattern and severity of bone involvement in the individual patient requires the application of conventional and advanced radiographic techniques. The introduction of enzyme replacement therapy (ERT) for this inborn error of glycosphingolipid metabolism has focused great interest in determining the nature and extent of the bone responses with this mode of treatment. The multifactorial etiology of the bone complications necessitates a multifaceted approach, combining pharmacologic strategies with physical therapy and orthopedic intervention. As bone disease can lead to chronic pain and debility with a resultant adverse impact on quality of life, it is important that patients be monitored closely and that early intervention with ERT prior to established bone disease (infarction and fibrosis) be considered.     

Effect of olive, almond and walnut oil on cardiovascular risk factors in type 2 diabetic patients

Several studies have demonstrated the benefits of vegetable oil on cardiovascular risk factors in diabetes. The goal of the present study was to compare the effects of olive, almond and walnut oil on serum glucose, lipids and blood pressure in type 2 diabetic patients. In this cross over clinical study 24 hypercholesterolemic type 2 diabetic patients were recruited. Subjects consecutively assigned to consume 40 cc olive, almond and walnut oil daily over a 4-week period with a two-week washout period, accompanied by the Step I diet. Anthropometric measurements, HbA1c, lipid profile and serum glucose and blood pressure were measured initially and at the end of the study. Serum levels of total cholesterol (TC) and LDL-cholesterol at baseline and at the end of trial differed significantly after olive oil (P?=?0.007, P?=?0.02) and triglyceride (TG) after almond oil (P?=?0.02). When the differences of these laboratory levels between olive, almond and walnut were tested, no significant differences were found. Our findings showed olive oil could reduce significantly serum levels of TC and LDL. Almond consumption could decrease TG significantly. Our research could not show significant reduction in blood pressure.     

The reversibility of sperm quality after discontinuing nandrolone decanoate in adult male rats

Aim： To investigate the reversibility of the effect of nandrolone decanoate （ND） on sperm parameters after discontinuing the drug. Methods： Three groups of rats received peanut oil （control）, low and high doses of ND for 14 weeks, respectively. Each group was divided into subgroups A and B, in which rats were killed 14 and 28 weeks after initiating the injection, respectively. Results： Sperm count and motile sperm fraction were decreased in the subgroups A and B that received low and high doses of ND in comparison with the controls A and B, respectively. The sperm count and motile sperm fraction increased in the subgroups B that received low and high doses of ND in comparison with their corresponding subgroups A. The number of normal morphology sperm was decreased significantly in subgroups A receiving low and high doses of ND in comparison with the control subgroup A. However, this parameter was not decreased in subgroups B receiving low and high doses in comparison with the control subgroup B. The normal sperm morphology did not show any significant differences in the subgroups B in comparison with their corresponding subgroups A. Conclusion： The 14-week injection of low and high doses of ND decreases sperm quality and quantity in rats. These parameters were improved after discontinuing ND, but not recovered completely even when they are left untreated for 14 weeks.