Correlation Between Serum Homocysteine Levels and Carotid Intima-media Thickening in Hemodialysis Patients.

NTRODUCTION: Hyperhomocysteinemia is an important risk factor for cardiovascular disease in ESKD patients. Homocysteine, as an inflammatory factor, and carotid intima-media thickness (CIMT) could predict atherosclerosis in hemodialysis-treated ESKD patients. In this regard, the present study was conducted to investigate serum homocysteine level and its relationship with internal carotid intima thickness in ESKD patients undergoing routine hemodialysis. METHODS: This study comprised 56 ESKD patients, older than 40 years, undergoing hemodialysis for at least 1 year. All participants were taking Nephrovit for at least 6 months. The study participants were patients who underwent ultrasonography for CIMT determination and laboratory test Results. There was no statistically significant relationship between the mean homocysteine level and hypertension, diabetes mellitus, duration of dialysis, and body mass index (BMI). Among the study participants, the results also showed that the mean value of CMIT homocysteine and C-reactive protein (CRP) were 0.89 millimeters, 30.44 (mcmol/L), and 35.60 mg/L; respectively. Despite hypertension, there was a significant difference between the mean values of CMIT in patients with diabetes mellitus and those who had been on dialysis for a longer period (more than 3 years). Also, the mean value of CMIT was significantly higher in obese patients than those with normal BMI. None of the other variables including homocysteine serum level, C-reactive protein (CRP), and CMIT showed a significant correlation. CONCLUSION: The results of the study suggest that there is no relationship between serum homocysteine level and carotid intima-media thickness in hemodialysis patients.  DOI: 10.52547/ijkd.7424.

The effect of oral probiotics on CD4 count in patients with HIV infection undergoing treatment with ART who have had an immunological failure.

INTRODUCTION: Probiotics are live microorganisms that, when administered in appropriate colonies, can delay the destruction of the immune system and contribute to the maintenance of immunity in HIV patients. Probiotics play an important role in stimulating natural killer T cells, strengthening the functional gut barrier, and reducing systemic inflammation. METHODS: This study was a randomized double-blind clinical trial involving 30 patients treated with antiretroviral therapy who had experienced immunological failure despite HIV viral suppression. Patients were divided into two equal groups of 15, group (B) received two probiotic capsules daily with a colony count of 109 CFU per capsule containing seven strains, after 3 months they were examined for CD4+ counts by flow cytometry, and after a 1-month washout period the participants who had received probiotics were switched to placebo, and the participants who had received placebo were given probiotics for 3 months, and they were examined for CD4+ counts 7 months after the start of the study. RESULTS: In the first group (A), administration of the placebo resulted in a decrease in CD4 count in the first 3 months (from 202.21 to 181.79, p value < .001), which may be due to the natural history of the disease. After probiotics administration, CD4 count increased significantly (from 181.79 to 243.86, p value < .001). Overall, after 7 months of study, there was a significant increase in the mean CD count from 202.21 to 243.86 (p value < .001). In the second group (B), the administration of probiotics in the first 3 months of the study resulted in a significant increase in the mean CD4 count (from 126.45 to 175.73, p value < .001). Termination of treatment with probiotics resulted in a significant decrease (from 175.73 to 138.9, p value < .001) but overall the CD4 count at the end of the study was significantly higher than at baseline (p value < .001).

Early amiodarone pneumonitis: A case report.

Consider amiodarone pneumonitis as an important differential diagnosis of ARDS, especially in clinically ill patients who recently received Intravenous amiodarone.

Focal nodular hyperplasia in a 14-year-old child: A case report.

BACKGROUND: Focal nodular hyperplasia (FNH) is a benign rare liver neoplasm in children and includes only 2% of all pediatric liver tumors. Here we reported the case of a 14-year-old girl with vague flank pain who was managed conservatively. CASE PRESENTATION: Our case is a 14-year-old child (female), with a 5 cm diameter lesion in the right lobe of the liver in CT scan, and histologic findings compatible with FNH. A solid mass lobulated contour, intense enhancement with a hypodense central area, possibly indicative of central scar, was seen. Despite her mild flank pain we did not insist on surgical resection and managed her conservatively. Her pain resolved 2 weeks later and an imaging follow-up with ultrasound 6 months later showed no increase in size or numbers. CONCLUSION: FNH is an uncommon mass lesion in children. Our patient had mild symptomatic severity, and several guidelines recommend surgical treatment in this condition, but our team performed conservative and medical treatment for her and got the desired result. Therefore, the combination of these factors raises the importance of introducing the case. According to FNH's nature, stability, complications, and evaluation of pain are essential to avoid unnecessary surgeries.

Clinical significance of prognostic nutrition index in hospitalized patients with COVID-19: Results from single-center experience with systematic review and meta-analysis.

BACKGROUND: We aimed to ascertain risk indicators of in-hospital mortality and severity as well as to provide a comprehensive systematic review and meta-analysis to investigate the prognostic significance of the prognostic nutrition index (PNI) as a predictor of adverse outcomes in hospitalized coronavirus disease 2019 (COVID-19) patients. METHODS: In this cross-sectional study, we studied patients with COVID-19 who were referred to our hospital from February 16 to November 1, 2020. Patients with either a real-time reverse-transcriptase polymerase chain reaction test that was positive for COVID-19 or high clinical suspicion based on the World Health Organization (WHO) interim guidance were enrolled. A parallel systematic review/meta-analysis (in PubMed, Embase, and Web of Science) was performed. RESULTS: A total of 504 hospitalized COVID-19 patients were included in this study, among which 101 (20.04%) patients died during hospitalization, and 372 (73.81%) patients were categorized as severe cases. At a multivariable level, lower PNI, higher lactate dehydrogenase (LDH), and higher D-dimer levels were independent risk indicators of in-hospital mortality. Additionally, patients with a history of diabetes, lower PNI, and higher LDH levels had a higher tendency to develop severe disease. The meta-analysis indicated the PNI as an independent predictor of in-hospital mortality (odds ratio [OR] = 0.80; P < .001) and disease severity (OR = 0.78; P = .009). CONCLUSION: Our results emphasized the predictive value of the PNI in the prognosis of patients with COVID-19, necessitating the implementation of a risk stratification index based on PNI values in hospitalized patients with COVID-19.

Catalytic and networking effects of carbon black on the kinetics and conversion of sulfur vulcanization in styrene butadiene rubber.

The present work discusses the effects of carbon-black (CB) on the kinetics and conversion of sulfur vulcanization in styrene butadiene rubber (SBR) compounds. Kinetic studies revealed that the onset of the vulcanization reaction shortens monotonically by incorporation of CB, but the rate of vulcanization goes through a maximum at a critical loading of CB. It was demonstrated that CB has two roles in the kinetics of vulcanization: a catalytic effect on accelerating the initial reactions among vulcanization agents and a networking effect on retarding the crosslinking of macro-radicals. It was shown that the latter effect dominates the former one at high concentrations of CB where the rubber-mediated network of CB is formed and a large portion of rubber is immobilized as bound rubber. By using two types of CBs with very different specific surface areas, it was discussed that the critical loading at which the retarding effect begins coincides with the rheological percolation threshold of CBs. Moreover, conversion of vulcanization under isothermal conditions was continuously reduced as the concentration of CBs increased. This was correlated to the magnitude of the physical restrictions exerted by CBs, depending on the specific surface area of each CB. However, it was also shown that this restriction could be alleviated at higher temperatures during non-isothermal vulcanization, which enhances the degree of conversion in crosslinking.

Large-scale genetic perturbations reveal regulatory networks and an abundance of gene-specific repressors.

To understand regulatory systems, it would be useful to uniformly determine how different components contribute to the expression of all other genes. We therefore monitored mRNA expression genome-wide, for individual deletions of one-quarter of yeast genes, focusing on (putative) regulators. The resulting genetic perturbation signatures reflect many different properties. These include the architecture of protein complexes and pathways, identification of expression changes compatible with viability, and the varying responsiveness to genetic perturbation. The data are assembled into a genetic perturbation network that shows different connectivities for different classes of regulators. Four feed-forward loop (FFL) types are overrepresented, including incoherent type 2 FFLs that likely represent feedback. Systematic transcription factor classification shows a surprisingly high abundance of gene-specific repressors, suggesting that yeast chromatin is not as generally restrictive to transcription as is often assumed. The data set is useful for studying individual genes and for discovering properties of an entire regulatory system.

Comparison of the effect of three cements on prevention of enamel demineralization adjacent to orthodontic bands.

BACKGROUND AND AIMS: This in vitro study was designed to compare enamel demineralization depths adjacent to bands cemented with zinc polycarboxylate, glass ionomer (GI) and resin-modified glass ionomer (RMGI), in order to achieve minimal enamel demineralization during orthodontic treatment. MATERIALS AND METHODS: Sixty fully developed extracted third molars were randomly divided into three testgroups each containing 20 samples, used to cement orthodontic bands with zinc polycarboxylate, GI and RMGI. All samples were demineralized using White method using hydroxyapatite, latic acid and Carbapol for in vitro caries simulation, and then, immersed in 10% solution of methylene blue. The mean depth of dye penetration was assessed up to 0.1 millimeter, reflect-ing the depth of enamel demineralization. One way ANOVA and LSD statistical tests were employed to evaluate significant differences among groups. RESULTS: The highest dye penetration depth was seen in zinc polycarboxylate group, followed by GI, and RMGI groups, respectively, with significant differences among each two groups (P < 0.05). CONCLUSION: The use of RMGI cement seems to present significantly better prevention of enamel demineralization adja-cent to orthodontics bands.