Comparing the effect of induction therapy with or without antithymocyte globulin on renal allograft outcomes in live-donor kidney transplant recipients.

Background: This study aimed to investigate the effectiveness of antithymocyte globulin (ATG) in low-risk live-donor kidney transplant recipients (LDKTRs). Methods: In this cohort study, 114 LDKTRs were analyzed in 2 groups of ATG induction therapy (n=77) and control (n=37). In this study, 500 mg pulse therapy with methylprednisolone was provided for both groups for 3 days. In addition, one mg/kg of daily ATG was prescribed for 4 days in ATG induction group. Serum creatinine (Cr) was measured at 3, 7, 30, 90, and 180 days after surgery and discharge day. Acute rejection (AR) was confirmed based on biopsy or rise in serum Cr by three-tenths from baseline if other causes had been ruled out. Survival analysis was used by Stata14 and p < 0.05 was considered significant. Results: Cr changes were not significantly different between ATG induction therapy and control group in all follow-up periods (2.26 and 1.07 in ATG vs 2.26 and 1.03 in control group from the third day; (p=0.999) to the sixth month (p=0.735)). There was no significant difference between the 2 study groups in AR incidence (11.7% in ATG vs 10.8% in control group, P = 0.890) and its time (9.6 in ATG vs 9.8 in control group, p=0.695). Recipients factors were baseline Cr >10 mg/dL (p=0.055), blood group AB (p=0.007), no postoperative pulse therapy with methylprednisolone (PM) (p=0.005); and donors' factors were age ≤ 30 years (p=0.022) and blood group AB (p=0.006). Also, based on the log rank analysis, recipient-donor weight difference of 0 to 5 kg (p=0.047) had a significant association with earlier AR. Exploring these effects simultaneously by Cox regression analysis showed only significant results for recipients' baseline Cr (p=0.040) and postoperative therapy with PM (p=0.014). Conclusion: Both strategies of induction therapy had the same good results based on Cr decrease. Recipients' baseline Cr and postoperative therapy with PM were the predictors of survival time of the kidney (AR).

Comparison of The Efficacy and Safety of Palomo, Ivanissevich and Laparoscopic Varicocelectomy in Iranian Infertile Men with Palpable Varicocele.

BACKGROUND: This study aimed to compare the effects of three commonly used varicocelectomy techniques namely, open retroperitoneal ligation (Palomo), open inguinal ligation (Ivanissevich) and laparoscopy, in Iranian infertile men. MATERIALS AND METHODS: This retrospective study was conducted on 70 infertile men with palpable varicocele who underwent one of the varicocelectomy techniques namely, Palomo, Ivanissevich, or laparoscopy. Basic information about semen parameters were collected and registered prior to the surgery. Three months after the surgery, semen parameters and surgical complications were investigated in all patients. RESULTS: The Palomo technique was significantly associated with fewer complications compared to other techniques (P=0.006). The means of sperm concentration, normal motility and normal morphology were significantly different among the three groups after surgery (P=0.025, 0.023 and 0.047, respectively). However, after adjustment for potential confounders, in addition to the baseline values of semen parameters, significant differences were observed only in sperm concentration among the groups (P=0.040). CONCLUSION: Varicocelectomy improved sperm parameters. The Ivanissevich technique was more effective in improving sperm concentration compared to the laparoscopic method. The lowest rates of complications were related to the Palomo technique.

Trend of Changes in Serum Albumin and Its Relation with Sex, Age, and BMI Following Laparoscopic Mini-gastric Bypass Surgery in Morbid Obese Cases.

BACKGROUND: The aim of this study is to investigate the pattern of changes in serum albumin level after mini-gastric bypass (MGB) and its association with gender, age, and body mass index (BMI) of the patients. METHODS: This cohort study was conducted on 196 morbidly obese patients undergoing MGB followed for 1 year. The data on BMI, serum albumin level, demographic, anthropometric, biochemical variables and comorbidities were gathered before and after (3, 6, and 12 months) surgery. The trend of changes in BMI and serum albumin of the patients was investigated by repeated measures tests using general linear model (GLM) and generalized estimating equations (GEE) approaches. RESULTS: The mean age, baseline median BMI, and albumin of the patients were 41.34 ± 11.03 years, 44.54 kg/m2, and 4.00 g/dl, respectively. There was a chronologically significant trend of decline in BMI (P < 0.001). GEE demonstrated no chronologically significant trend in serum albumin (P = 0.278). The trend of changes in albumin was significantly associated only with age grouping and baseline serum albumin level (P = 0.017 and 0.001, respectively). This trend had fluctuations in patients older than 40 years with baseline serum albumin level of 3.50-3.90 g/dl. For patients with any age and baseline serum albumin level of 4.00-4.90 g/dl, this trend was stable in all periods of follow-up. CONCLUSION: MGB is an effective technique to lose weight. The trend of changes in serum albumin level was affected by its baseline levels and age.

Correction to: Trend of Changes in Serum Albumin and Its Relation with Sex, Age, and BMI Following Laparoscopic Mini-gastric Bypass Surgery in Morbid Obese Cases.

Due to a production error the bottom portion of Fig. 3 was missing in the version of this article originally published online.

Trends in health burden of untreated water and insanitary environments in Iran, 1990-2010: Findings from the global burden of disease study 2010.

Background: Water, sanitation and hygiene have a very important role in public health. Poor sanitation is the cause of water contamination, which causes many types of diseases. The aim of this paper was to present the attributable death and disability adjusted life year (DALYs) of untreated water and insanitary environments from 1990 to 2010 in Iran. Methods: In the Global Burden of Disease 2010 study, using the comparative risk assessment, the proportion of death and DALYs attributable to untreated water source and insanitary environment has been calculated in 1990 to 2010. The certain outcomes were intestinal infectious diseases for both untreated water source and insanitary environments. Estimated attributable deaths and DALYs were reported with 95% uncertainty interval (UI). Results: DALY number for untreated water source and insanitary environments was 5838 (95% UI: 198- 14837) in 1990, which decreased to 326 (95% UI: 9-863) in 2010 and the percent of decrease was 94.42%. In addition, DALY rate was 5667 (95% UI: 192-14402) DALY per 100,000 in 1990, which decreased to 453 (95% UI: 13-1199) DALY per 100,000 in 2010 and the percent of the reduction was 92.01%. The greatest percentage of decrease in the attributed number of deaths was also found in the late neonatal age group (95.45%). Conclusion: A significant decrease has occurred in a number of DALYs and deaths between 1990 and 2010, which was attributed to the development of new water systems and environmental sanitations in Iran.

Trends in health burden of ambient particulate matter pollution in Iran, 1990-2010: findings from the Global Burden of Disease study 2010.

This paper aims to report the assessment of trends in deaths and disability-adjusted life years (DALYs) attributed to ambient particulate matter (PM) pollution from 1990 to 2010 by sex and age in Iran. We used the data of the Global Burden of Disease (GBD) 2010 Study, and then we extracted its data on Iran for the years 1990, 2005, and 2010. The proportion of deaths and the DALYs caused by specific risk factors were assessed by using the comparative risk assessment and calculating the attributed burden of exposure level to each risk factor compared with the theoretical minimum level of risk exposure. Uncertainties in distribution of exposure, relative risks, and relevant outcomes calculation were disseminated into the estimates of the attributable deaths and DALYs. We found that the age-standardized death rate attributed to ambient PM pollution decreased to 27.90 cases per 100,000 populations from 1990 to 2010 [86, 95% uncertainty interval (UI) 76-97 to 62; 95% UI 54-71 per 100,000 populations, respectively]. This was mainly because of greater decrease in cardiovascular diseases (CVDs) than in the other diseases attributed to PM pollution. Despite a decrease in the total DALYs and mortality rate attributed to PM pollution, the death percent increased by 6.94%, 95% UI 6.06-7.90% from 1990 to 2010. The number of the DALYs and death in age groups of more than 70 years increased in 2010 compared to that in 1990. The median percent change of the DALYs and death for all age groups shows that the DALYs and death increased by 6% (95% UI 8-19%) and 45% (95% UI 30-60%), respectively, in 2010 in comparison to that in 1990. The increase in the DALYs and mortality attributable to PM pollution emphasizes the necessity of the effective interventions for improving air quality, as well as for increasing the public awareness to reduce the exposure of vulnerable age groups to PM pollution.