Comparison of serum neutrophil gelatinase-associated lipocalin [NGAL] with serum creatinine in prediction of kidney recovery after renal transplantation

Because of some insult to kidney during transplantation, assessment of kidney function after the procedure is essential. It would be ideal to find a marker better than creatinine to early predict the acute kidney injury. To compare with creatinine the predictive value of serum neutrophil gelatinase-associated lipocalin [NGAL] in detecting kidney recovery after renal transplantation. We studied 33 patients who received kidney transplantation [deceased [n=20] and live [n=13]] during a 6-month period in 2010. Serum NGAL and creatinine, hemoglobin, and blood glucose were measured at 0,12, 24,48, and 72 hours after transplantation. The need for dialysis and kidney function in one week were studied. There were 16 men and 17 women with the meantSD age of 36.3 +/- 12.2 [range: 14-58] years. Of the studied patients, 6 had delayed graft function [DGF; hemodialysis within the first week of transplant]; 9 had slow graft function [SGF; serum creatinine reduction from transplantation to day 7 <70%], and 23 had immediate graft function [IGF; reduction in serum creatinine >70%]. At any time, serum NGAL, and creatinine levels were significantly higher among patients with DGF [p=0.024] and SGF [p=0.026] compared with those with IGF. However, in those who got IGF vs non-IGF, serum creatinine levels were not significantly different [p=0.59] but serum NGAL levels differed significantly[p=0.020]. Receiver-operating characteristic [ROC] curve and area under curves [AUCs] of serum NGAL and serum creatinine levels on the first post-transplantation day had similar significance in predicting the patient's need to dialysis in the first week. However, using AUC of serum creatinine was not helpful in predicting non-IGF, compared to serum NGAL. The AUCs of the serum NGAL were 0.70 [95% CI: 0.52-0.89] and 0.76 [95% CI: 0.59-0.93] after 12 and 24 hours, respectively [p<0.05]. The highest AUC [0.82] was attributed to serum NGAL of 24 hour [p=0.002]. Serum NGAL level especially 24 hours post-transplantation, seems to be an early accurate predictor of both the need to dialysis and slow graft function within the first week of kidney transplantation

Association of myocardial infarction with stressful life events and psychiatric symptoms: a population based survey

Psychosocial factors such as depression, hostility, social isolation are associated with increased risk of coronary heart disease. We aimed to determine the association of psychiatric symptoms and psychosocial factors with myocardial infarction [Ml]. We performed a secondary analysis of data from a population-based survey of Iranians aged 18-65 years using standardized psychosocial instruments. Of the 2158 participants, 51 had suffered an Ml. In univariate analysis; number of stressful life events, stressfulness, somatization, depression, anxiety, phobic anxiety and psychoticism were significantly associated with Ml [P< 0.05]. In multivariate logistic regression, interpersonal sensitivity [P = 0.047], phobic anxiety [P = 0.016], number of stressful life events [P =0.054], stressfulness [P= 0.057] and age [P= 0.001] remained at significantly associated with MI

Quality of life in patients hospitalized with heart failure: a novel two questionnaire study

Heart failure [HF] is a common disease with high health care costs and high mortality rate Knowledge of the health-related quality of life [QOL] outcomes of HF may guide decision making and be useful in assessing new therapies for population. Yet little is known about QOL of HF patients in Iran. To assess health related QOL of patients with HF with two different instrument and to correlate these two measures and to assess the role of relevant factors. Analytic cross sectional study was conducted involving 230 adult patients hospitalized with HF, demographic data and health -related quality of life were determined by interview; for assessing of quality of life was used SF-36 and Minnesota questionnaires. Simple random sampling from ward patients list choose patients. Patients had no other man diseases that affected their quality of life. 118 female [53.3%] and 112 male [48.7%] with mean age of 51.4 +/- 13.18 were collected. 61 patients [26.5%] were smoker and 100 patients [43.5%] had positive familial hearth disease history. Quality of life in some subscale: Physical functioning, Role physical and vitality, and Minnesota scare affected from patients age. Male patients had better quality of life than female in Minnesota scale and physical functioning, body pain, general health, vitality and emotional well-being. Duration of diagnosis affected Minnesota scale and role physical. Positive familial heart disease history affected physical functioning. Iranian patients have worse quality of life than other patients. This shows patients age, sex, duration of diagnosis, smoking and positive familial hearth disease history affected quality of life in heart failure patients