RESUMO
Background: IgA nephropathy [IgAN] is the most common primary glomerulonephritis diagnosed based on renal biopsy. Mesangial IgA deposits along with the proliferation of mesangial cells are the histologic hallmark of IgAN. Non-invasive diagnostic tools may help to prompt diagnosis and therapy. The discovery of potential and reliable urinary biomarkers for diagnosis of IgAN depends on applying robust and suitable models. Applying two multivariate modeling methods on a urine proteomic dataset were obtained from IgAN patients, and comparison of the results of these methods were the purpose of this study
Methods: Two models were constructed for urinary protein profiles of 13 patients and 8 healthy individuals, based on sparse linear discriminant analysis [SLDA] and elastic net [EN] regression methods. A panel of selected biomarkers with the best coefficients were proposed and further analyzed for biological relevance using functional annotation and pathway analysis
Results: Transferrin, a1-antitrypsin, and albumin fragments were the most important up-regulated biomarkers, while fibulin-5, YIP1 family member 3, prasoposin, and osteopontin were the most important down-regulated biomarkers. Pathway analysis revealed that complement and coagulation cascades and extracellular matrix-receptor interaction pathways impaired in the pathogenesis of IgAN
Conclusion: SLDA and EN had an equal importance for diagnosis of IgAN and were useful methods for exploring and processing proteomic data. In addition, the suggested biomarkers are reliable candidates for further validation to non-invasive diagnose of IgAN based on urine examination
RESUMO
Objectives: To evaluate the odds for unfavorable outcome of each risk factor and a combination of them in patients with aneurysmal subarachnoid hemorrhage [SAH] undergoing surgical clipping in Southern Iran
Methods: A total of 367 patients who were operated between March 2007 and March 2016 due to aneurysmal SAH were analyzed according to patients' factors, aneurysm characteristics and intra-operative data. Correlation between outcomes of patients measured by modified Rankin Scale at 6-months with each factor were analyzed. Market Basket analysis was also used to identify the odds of unfavorable outcome for combinations of factors
Results: A total of 367 patients, including 199 females and 168 males with a mean age of 47.27+/- 11.53 years, who underwent operation between March 2007 and March 2016 due to aneurysmal SAH were analyzed. Unlike gender, higher age was associated with unfavorable outcome. Ischemic heart disease, Duration of operation and amount of bleeding were also found to increase the odds of unfavorable outcome [p=0.01, 0.02, 0.04 respectively]. DM, Cigarette smoking and opium addiction as well as the location and multiplicity of aneurysms did not have an adverse effect on outcome. [p>/=0.05]
Conclusion: Among the numerous risk factors presumed to result in unfavorable outcome in aneurysmal SAH, only older age, duration of operation more than 60 minutes, previous known history of ischemic heart disease, poorer clinical grade and intra-operative bleeding more than 500 mL were found to be significant factors
RESUMO
Objectives: To determine serum biomarkers in detection of preeclampsia severity among pregnant women
Methods: Among 450 pregnant women with various severity of preeclampsia, serum biomarkers ofaspartate aminotransferase [AST], alanine aminotransferase [ALT], lactate dehydrogenase [LDH], hemoglobin [Hb], platelet count [PLT], uric acid, direct bilirubin, total bilirubin, creatinine, and alkaline phosphatase were compared using area under the Receiver operating characteristic [ROC] curve and Area Under the Curve [AUC]
Results: The mean age of women was 30.63 +/- 6.43 years and with mean gestational age of 34.69 +/- 3.97 weeks. The mean level of LDH, ALT, uric acid, and creatinine were significantly higher in the women with severe type of preeclampsia compared to those with mild type. LDH level had ROC and AUC of more than 0.80, with highest sensitivity, and moderatespecificityin comparison to other markers
Conclusion: Biomarkers such as ALT, uric acid, and LDH were shown to be prognostic in detection of theseverity of preeclampsia. LDH was demonstrated to significantly be a better prognostic test in detection of preeclampsia severity
RESUMO
Background: preterm labor and birth are associated with several neonatal complications including respiratory distress syndrome and intraventricular hemorrhage. Differentiating true and false labor pain is a dilemma to obstetricians
Objective: to elucidate the role of cervical length measurement in prediction of birth in pregnant women with threatened preterm labor
Materials and Methods: in this double blind randomized clinical trial, 120 women with gestational age <34 wk who presented painful uterine contractions randomly assigned to undergo measurement of cervical length. Patients were registered in the hospital and a unit number was given. Based on the unit numbers, patients were randomly assigned to two groups using a computerized random digit generator. All participants were managed accordingly [n=65] or to receive tocolysis as planned [n=55]. Tocolysis was prescribed when cervical length was <15 mm while those with cervical length >/=15 mm were managed expectantly. Delivery within 7 days of the presentation was the primary outcome
Results: this RCT showed in case group, 78.9% of patient with cervical length <15 mm were delivered within 7 days and only 21.1% of them maintained their pregnancy. Of those with cervical length >/=15 mm, only 15.2% were delivered within the study period and the rest [84.8%] maintained their pregnancy [p<0.001]
Conclusion: "our results indicate that in women who presented preterm labor symptoms, cervical length measurement will result in decreased unnecessary tocolytic treatment. Women with cervical length >/=15mm should not receive tocolysis, however, withholding corticosteroid therapy in these patients needs further evidence