The effect of home-based aerobic training and vitamin D supplementation on fatigue and quality of life in patients with multiple sclerosis during COVID-19 outbreak.

Objectives: Multiple sclerosis (MS) is the most common neurological disease that causes disability in the nervous system, which reduces the quality of life (QoL). Studies have shown positive effects of therapeutic exercise with supplementation on motor- and cognitive function, fatigue, and QoL in individuals with MS. The purpose of this study was to investigate the effect of home-based aerobic training (AT) and vitamin D (Vit D) supplementation on fatigue and QoL in patients with MS during the COVID-19 outbreak. Equipment and methods: We recruited 40 females (20-40 years) with MS (EDSS: 3-5). The subjects were then randomly assigned to one of four groups: AT (n = 9; 50-75 percent, 20-40 minutes per day, three days per week), Vit D supplementation (Vit D; n = 9; 50,000 IU one day per week), AT plus Vit D supplementation (AT + Vit D; n = 10), and sedentary control (C; n = 10 placebo). The data were analyzed using paired t-test and one-way analysis of variance and Tukey's post hoc test using SPSS 26 at a significance level of P < 0.05. Results: After eight weeks of intervention, fatigue grade markedly reduced in the AT + Vit D, AT, and Vit D groups); However, fatigue increased in the control group. QoL increased significantly in AT + Vit D, AT, and Vit D compared to C. Also, the results show that the AT + Vit D had significantly higher QoL than AT and Vit D. These findings suggest that therapeutic AT and Vit D supplementation effectively reduces fatigue and improves the QoL in female MS patients.

Objectifs: La sclérose en plaques (SEP) est la maladie neurologique la plus courante, et elle entraîne des troubles neurologiques qui impactent négativement la qualité de vie (QdV). Des études ont montré des effets positifs de l'exercice associé à une supplémentation sur les fonctions motrices et cognitives, la fatigue et la qualité de vie chez les personnes atteintes de SEP. Le but de cette étude était d'étudier l'effet d'un entraînement aérobie réalisé à domicile (AT) et d'une supplémentation en vitamine D (Vit D) sur la fatigue et la qualité de vie de patientes atteintes de SEP pendant l'épidémie de COVID-19. Matériel et méthodes: Nous avons recruté 40 femmes (20 à 40 ans) atteintes de SEP (EDSS: 3­5). Les sujets ont ensuite été répartis au hasard dans l'un des quatre groupes: AT (n = 9; 50­75 %, 20­40 minutes par jour, trois jours par semaine), supplémentation en vitamine D (Vit D ; n = 9 ; 50 000 UI un jour par semaine), AT plus vitamine D (AT + Vit D ; n = 10) et contrôle sédentaire (C ; n = 10 placebo). Les données ont été analysées à l'aide d'un test t pour valeurs appariesé, d'une analyse de variance à un facteur complété par un test post hoc de Tukey à l'aide de SPSS 26 avec un niveau de signification fixé à p < 0,05. Résultats: Après huit semaines d'intervention, le degré de fatigue est nettement réduit dans les groupes AT + Vit D, AT et Vit D) ; Par contre, la fatigue a augmenté dans le groupe témoin. La qualité de vie a augmenté de manière significative dans AT + Vit D, AT et Vit D par rapport à C. De plus, les résultats montrent que l'AT + Vit D avait une qualité de vie significativement meilleure que AT et Vit D. Ces résultats suggèrent que la supplémentation thérapeutique en AT et Vit D réduit la fatigue et améliore la qualité de vie chez les femmes atteintes de SEP.

Use of Basiliximab with the Standard Immunosuppressive Protocol in Pediatric Renal Transplantation: A Double-Blind Randomized Clinical Trial.

BACKGROUND: Several randomized clinical trials performed on adult renal transplant recipients have shown a significant reduction in the incidence of acute rejection by using basiliximab as induction therapy. However, few studies have been conducted on kidney graft survival following the use of the drug among pediatric transplant recipients. OBJECTIVE: To address the efficacy and safety of basiliximab in the improvement of the survival of children with kidney transplants. METHODS: This randomized, double-blind single-center clinical trial was conducted on 28 children (57% male) who underwent live-unrelated renal transplantation. They were randomly assigned into an intervention group receiving basiliximab (10 mg in patients weighing <40 kg or 20 mg in patients ≥40 kg) as induction therapy in combination with the standard immunosuppressive regimen (n=14), or to the control group (n=14) receiving only the standard immunosuppressive regimen (without basiliximab). The outcome was assessed by the measurement of serum creatinine level before transplantation, and 24, 48, and 72 hours as well as 3, 6, and 12 months post-transplantation. The estimated glomerular filtration rate at 12 months post-transplantation and graft survival were also measured. The number of acute rejection episodes in transplant recipients was also considered. RESULTS: The mean±SD age of participants was 12.3±4.2 years. No difference was observed between the two groups in terms of serum creatinine level before and after transplantation at various time points. The mean±SD eGFR at 12 months post-transplantation was 87.8±8.4 in the basiliximab and 85.2±5.8 in the control group (p=0.37). No significant difference was observed between the two groups in terms of acute rejection episodes (25% in basiliximab and 33% in the control group). The graft survival at 1-year post-transplantation was 93% in the basiliximab and 86% in the control group (p=0.54). CONCLUSION: Adding basiliximab to the standard immunosuppressive regimen may not improve the graft survival.

House dust mite sublingual-swallow immunotherapy in perennial rhinitis: a double-blind, placebo-controlled Iranian study.

Sensitivity to house dust mite allergens in the development of allergic rhinitis has a key role. In this study, the clinical and immunological effects of high dose Dermatophagoides farinae sublingual immunotherapy (SLIT) versus placebo were compared. Forty poly-sensitized patients, ages 6-33 years, with allergic rhinitis and positive allergic reaction to the mites were enrolled in the study. Twenty-one patients were placed in the SLIT group and 19 in the placebo group. Expression levels of IL-10, TGF-ß, FOXP3 and IL-17 were measured by using real-time PCR before and after the administration of sublingual immunotherapy. Clinical efficacy was estimated by the reduction rate of symptom/medication scores in the SLIT group compared with placebo treatment. After 6 months of SLIT, TGF-ß expression levels were increased compared to pre-treatment (P less than 0.05). SLIT with D. Farinae extract is an effective treatment for poly-sensitized patients with allergic rhinitis. TGF-ß mediated T-cell suppression may be an important mechanism in the first 6 months of SLIT.

Mycophenolate mofetil in pediatric renal transplantation.

INTRODUCTION: Since kidney transplantation is the therapy of choice for children with end-stage renal disease (ESRD), we investigated the effects of mycophenolate mofetil (MMF) in pediatric renal transplantation. METHODS AND SUBJECTS: Two hundred sixteen children received renal transplants between 1985 and 2003: 100 patients received MMF with cyclosporine and prednisolone (cases), and 116 patients, azathioprine with cyclosporine and prednisolone (controls). RESULTS: The MMF group (100 patients) showed better graft survival and function than the AZA group (116 patients). Patients who received MMF immediately after transplantation experienced less graft loss and acute rejection episodes in the first 3 months after transplantation (P < .05). Patients who received MMF at the time of diagnosis of chronic rejection had stable renal function and remarkably better graft survival than those with chronic rejection who received AZA instead of MMF (P < .05). CONCLUSION: This study suggests that MMF may stop persistent graft dysfunction in chronic rejection, improving graft survival in the short and long terms posttransplantation.

Outcome of renal transplantation in children with low urinary tract abnormality.

INTRODUCTION: Patients with end-stage renal disease and lower urinary tract abnormality are often considered high risk for renal transplantation. METHODS AND SUBJECTS: To examine the degree of risk, we studied patients who received renal transplants between 1985 and 2003. Forty eight patients had congenital lower urinary tract anomalies and 168 patients comprised a control group without these anomalies. RESULTS: Mean age and distribution of sex were not significantly different between the case and the control group. Among patients with anomalies, 8% had delayed graft function; 75%, acute rejection; and 39.5%, chronic rejection. Among the controls 2.3% had delayed graft function; 59%, acute rejection; and 35%, chronic rejection. None of these differences was significant. Mean survival time was 6 years in affected patients and 7.3 years in the control group (P = .7). Among patients with anomalies the rate of graft survival in the first year after transplantation was 90%; and those in the third, fifth, and seventh years, 76%, 65%, and 40%, respectively. For the controls, the graft survivals were 88% at 1 year; 73% at 3 years; 70% at 5 years; and 49% at 7 years after transplantation. CONCLUSION: This study showed that a history of lower urinary tract anomalies had no effect on graft function. Graft survival was not different among these patients compared with patients free of these anomalies.

A retrospective study of poisoning in Tehran.

OBJECTIVE: To examine the causes and mortality of poisoning in Tehran. METHODS: The 7000 poisoning cases referred to Loghman-Hakim Hospital in Tehran over six months in 1994 were evaluated retrospectively. RESULTS: The overall female to male ratio was 1.8:1. Most poisonings occurred in the age range 2-6 y for children and 21-40 y for adults. Oral ingestion was the most common route of intoxication. In children, boys had a higher frequency of poisonings than girls. Most cases of children were referred to the hospital between 8 am and 8 pm. In adults referred to the hospital, there was little diurnal variation in poisoning presentations. In adults, drugs were the most common cause of intoxication (60.2%). Of these, benzodiazepines (24.5%) were the most frequent, followed by antidepressants (20.5%) and analgesics (18%). Pesticide and opiate intoxications were also commonly observed. In children, after drugs (32.1%), hydrocarbons were the most frequent cause of poisoning (19.2%). Pesticide poisonings were most often fatal (19.2%), followed by barbiturates (18.6%) and opiates (16.2%). Organophosphate insecticides were responsible for 57% of total pesticide poisoning cases. Of the deaths, 87.5% were attributed to suicide. CONCLUSION: The majority of poisoning cases in adults occur intentionally and in children accidentally.