Green synthesis of selenium nanoparticles and evaluate their effect on the expression of ERG3, ERG11 and FKS1 antifungal resistance genes in Candida albicans and Candida glabrata.

Drug resistance in Candida species has been considerably increased in the last decades. Given the opposition to antifungal agents, toxicity and interactions of the antimicrobial drugs, identifying new antifungal agents seems essential. This study assessed the antifungal effects of nanoparticles (NPs) on the standard strains of Candida albicans and Candida glabrata and determined the expression genes, including ERG3, ERG11 and FKS1. Selenium nanoparticles (Se-NPs) were biosynthesized with a standard strain of C. albicans and approved by several methods including, ultraviolet-visible spectrophotometer, X-ray diffraction technique, Fourier-transform infrared analysis, field-emission scanning electron microscopy and EDX diagram. The antifungal susceptibility testing performed the minimum inhibitory concentrations (MICs) using the CLSI M27-A3 and M27-S4 broth microdilution method. The expression of the desired genes was examined by the real-time PCR assay between untreated and treated by antifungal drugs and Se-NPs. The MICs of itraconazole, amphotericin B and anidulafungin against C. albicans and C. glabrata were 64, 16 and 4 µg ml-1 . In comparison, reduced the MIC values for samples treated with Se-NPs to 1 and 0·5 µg ml-1 . The results obtained from real-time PCR and analysis of the ∆∆Cq values showed that the expression of ERG3, ERG11 and FKS1 genes was significantly down-regulated in Se-NPs concentrations (P < 0·05). This study's evidence implies biosafety Se-NPs have favourable effects on the reducing expression of ERG3, ERG11 and FKS1 antifungal resistance genes in C. albicans and C. glabrata.

Detection of Canine Parvovirus Type 2 by Designing Multiple Methods and Genetic Characterization in Iran.

Canine parvovirus infection is the most highly infectious in dogs younger than six months. Our study aimed to design and optimize an In-house PCR Assay for Rapid Detection of parvovirus type 2 and compares it with REAL-TIME PCR and LAMP Assay and phylogenetic analysis. The virulence gene selected for the categories was vp2 for CPV-2. PCR products were cloned in pTZ57R/T plasmid for preparation of positive control. Determination of the specificity of primers was done with the negative control virus genomes, and the limit of detection was determined for the Homemade PCR, REAL-TIME PCR, LAMP, and to perform a phylogenetic study using partial vp2 gene sequences. Added analysis of PCR products using agarose gel electrophoresis for the vp2 gene showed 485bp, and GAPDH 900 bp bands, respective amplification using negative control genomes as template was negative. The least detectable copy number for the vp2 gene in a 25 µl PCR reaction equals 19 copies by homemade PCR, LAMP, and REAL-TIME PCR 25 and 21 copies, respectively. The phylogenetic analysis for the five field sequences formed three distinct clusters. The in-house PCR has advantages such as high specificity, sensitivity, and the ability to detect major CPV-2 pathogens. This assay may replace the previous laboratory methods and work as an essential supplement to the more time-consuming assays. Phylogenetic analysis is necessary for epidemiological studies to control and prevent disease.

Microplastics fouling and interaction with polymeric membranes: A review.

The emergence and accumulation of microplastics (MPs) in various aquatic environments have recently raised significant concerns. Wastewater treatment plants (WWTPs) have been identified as one of the major sources of MPs discharge to the environment, implying a substantial need to improve advanced techniques for more efficient removal of MPs. Polymeric membranes have been proven effective in MPs removal. However, fouling is the main drawback of membrane processes and MPs can foul the membranes due to their small size and specific surface properties. Hence, it is important to investigate the impacts of MPs on membrane fouling to develop efficient membrane-based techniques for MPs removal. Although membrane technologies have a high potential for MPs removal, the interaction of MPs with membranes and their fouling effects have not been critically reviewed. The purpose of this paper is to provide a state-of-the-art review of MPs interaction with membranes and facilitate a better understanding of the relevant limitations and prospects of the membrane technologies. The first section of this paper is dedicated to a review of recent studies on MPs occurrence in WWTPs aiming to determine the most frequent MPs. This is followed by a summary of recent studies on MPs removal using membranes and discussions on the impact of MPs on membrane fouling and other probable issues (abrasion, concentration polarisation, biofouling, etc.). Finally, some recommendations for further research in this area are highlighted. This study serves as a valuable reference for future research on the development of anti-fouling membranes considering these new emerging contaminates.

Cost-effectiveness analysis of selective first-line use of biologics for unresectable RAS wild-type left-sided metastatic colorectal cancer.

Background: Evidence from a retrospective analysis of multiple large phase iii trials suggested that primary tumour location (ptl) in RAS wild-type metastatic colorectal cancer (wtRAS mcrc) might have predictive value with respect to response to drug therapies. Recent studies also show a potential preferential benefit for epidermal growth factor inhibitors (egfris) for left-sided tumours. In the present study, we aimed to determine the incremental cost-effectiveness ratio (icer) for the first-line use of an egfri for patients with left-sided wtRAS mcrc. Methods: We developed a state-transition model to determine the cost effectiveness of alternative treatment strategies in patients with left-sided mcrc:■ Standard of care■ Use of an egfri in first-line therapyThe cohort for the study consisted of patients diagnosed with unresectable wtRAS mcrc with an indication for chemotherapy and previously documented ptl. Model parameters were obtained from the published literature and calibration. The perspective was that of a provincial ministry of health in Canada. We used a 5-year time horizon and an annual discount rate of 1.5%. Results: Selecting patients for first-line egfri treatment based on left-sided location of their colorectal primary tumour was more effective than the standard of care, resulting in an increase in quality-adjusted life-years (qalys) of 0.226 (or 0.644 life-years gained). However, the strategy was also more expensive, costing an average of $60,639 more per patient treated. The resulting icer was $268,094 per qaly. A 35% price reduction in the cost of egfri would be needed to make this strategy cost-effective at a willingness-to-pay threshold (wtp) of $100,000 per qaly. Conclusions: Selective use of an egfri based on ptl was more cost-effective than unselected use of those agents; however, based on traditional wtp thresholds, it was still not cost-effective. While awaiting the elucidation of more precise predictive biomarkers that might improve cost-effectiveness, the price of egfris could be reduced to meet the wtp threshold.

EGFR rs11506105 and IFNL3 SNPs but not rs8099917 are strongly associated with treatment responses in Iranian patients with chronic hepatitis C.

Interferon lambda 3 (IFNL3) and epidermal growth factor receptor (EGFR) single nucleotide polymorphisms (SNPs) may play a key role in the spontaneous clearance of hepatitis C virus (HCV) and treatment responses. The aim of this study was to evaluate the effect of IFNL3 SNPs and EGFR rs11506105 on treatment outcomes in patients with chronic HCV (CHC). IFNL3 SNPs and EGFR rs11506105 were genotyped by PCR-restriction fragment length polymorphism and PCR-sequencing, respectively, in 235 naïve patients with CHC infection. The frequency of rapid virologic response (RVR), complete early virologic response (cEVR) and sustained virologic response (SVR) were 52.3%, 76.2% and 64.7% respectively. The results of this study showed that RVR was associated with ALT (P=0.015), AST (P=0.020), IFNL3 rs12979860 (CC) (P=0.043), rs12980275 (AA) (P=1 × 10-4), and EGFR rs11506105 (AA) (P=0.010), and IFNL3 rs12979860 (CC) (P=0.048), rs12980275 (AA) (P=0.022), and EGFR rs11506105 (AA) (P=0.006) were correlated with cEVR. HCV genotype (P=0.007), IFNL3 rs12979860 (CC) (P=0.023), IFNL3 rs12980275 (AA) (P=1 × 10-4), EGFR rs11506105 (AA) (P=0.005), RVR (P=1 × 10-4), and cEVR (P=0.003) were significant predictors for SVR. These results, for the first time, revealed that beside IFNL3 SNPs, EGFR rs11506105 is strongly associated with RVR, cEVR and SVR. EGFR rs11506105 besides IFNL3 SNPs could predict treatment responses in CHC patients.

Does the Oral Contraceptive Pill Increase Plasma Intercellular Adhesion Molecule-1, Monocyte Chemoattractant Protein-1, and Tumor Necrosis Factor-α Levels in Women with Polycystic Ovary Syndrome: A Pilot Study.

STUDY OBJECTIVE: Polycystic ovary syndrome (PCOS), the most common endocrinopathy of women, is a state of chronic low-grade inflammation and is closely linked to type 2 diabetes mellitus and cardiovascular disease. Oral contraceptive pills (OCPs), is the usual first choice of treatment in women with PCOS. Because OCP use has been linked to the risk of venous thrombosis and there are limited data on the effect of OCP use on the inflammatory state of women with PCOS, our objective was to compare the levels of intercellular adhesion molecule (ICAM)-1, tumor necrosis factor (TNF)-α, and monocyte chemoattractant protein (MCP)-1 between drug-naive and OCP-treated women with PCOS. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: Consequent to women diagnosed with PCOS on the basis of Rotterdam 2003 criteria, either treated with OCPs (ethinylestradiol 0.03 mg, levonogestrel-0.15 mg) for a period of 6 months (n = 50) or drug-naive (n = 51) were enrolled in this cross-sectional study. RESULTS: The mean ages of patients and control participants were comparable (21.99 ± 4.78 vs 21.92 ± 5.83 years; P = .947) as was body mass index (24.47 ± 3.92 vs 23.66 ± 3.43; P = .271). Clinical and androgen excess symptoms were significantly better in the OCP group compared with the drug-naive group (P = .01, P = .04). Total cholesterol and low-density lipoprotein cholesterol levels were significantly higher in the OCP group (P = .01). Plasma ICAM-1 levels, TNF-α levels, and MCP-1 levels showed a higher trend in patients but reached statistical significance only in cases of ICAM-1 and TNF-α (P = .01). CONCLUSION: OCP treatment of 6 months increases plasma ICAM-1, MCP-1, and TNF-α levels among women with PCOS, although OCPs significantly help in ameliorating features of hyperandrogenism and regularizing menstrual cycles. These cytokines correlate positively with many metabolic parameters including plasma glucose, lipids, and homeostatic model assessment-insulin resistance. Further investigation with well designed, randomized, longitudinal studies might help to ascertain the effect of OCPs on proinflammatory profiles among women with PCOS.

Mortality and Morbidity and Disease Free Survival after D1 and D2 Gastrectomy for Stomach Adenocarcinomas.

BACKGROUND: A number of randomized trials addressing alternative operative and multimodality approaches to gastric cancer have characterized early postoperative morbidity and mortality rates. The aim of this study was to compare mortality and morbidity and disease free survival after D1 and D2 gastrectomy for adenocarcinomas of the stomach MATERIALS AND METHODS: From June 2006 to January 2012, patients were selected according to information of the cancer administrator center of Ahvaz Jundishapur Medical University. The inclusion criteria were age between 20-85 years and histologically proven adenocarcinoma of the stomach without evidence of distant metastasis. Patients were excluded if they had previous or coexisting cancer or disability disease. In this research, D1 was compared to D2 gastrectomy. RESULTS: 131 patients were randomised, 49 allocated to D1 and 82 to D2 gastrectomy. The two groups were comparable for age, sex, site of tumors, and type of resection performed. The overall post-operative morbidity rate was 17.5%. Complications developed in 14.2% of patients after D1 and in 19.5% of patients after D2 gastrectomy (p=0.07). Postoperative mortality rate was 0.8% (one death); it was 2% after D1 and 0% after D2 gastrectomy. In this research disease free-survival after 3 years was 71.2 % with 63.2% after D1 and 76.8% after D2 gasterctomy. CONCLUSIONS: This study indicates that D2 gastrectomy with pancreas preservation is not followed by significantly higher morbidity and mortality than D1 resection. Based on the results of present study, D2 resection should be recommended as the standard surgical approach for resectable gastric cancer.

Anthelmintic, antimicrobial, antioxidant and cytotoxic activity of Caltha palustris var. alba Kashmir, India.

The methanolic extract obtained from the root portion of Caltha palustris var. alba was evaluated for its anthelmintic efficacy against gastrointestinal nematodes of sheep under both in vitro and in vivo conditions using worm motility inhibition (WMI) assay and fecal egg count reduction (FECR) assay, respectively. The extract was subjected to antimicrobial activity using agar-well diffusion method against different bacterial strains. In addition the extract was evaluated for cytotoxic and antioxidant activity against cultured THP-1(Leukemia), A-549 (Lung), HCT-15 (Colon), Cervix (HeLa) and PC-3(Prostrate) cell lines by SRB and DPPH radical scavenging assays. The extract used resulted in mean %WMI of 94.44%, as observed when the worms were put in lukewarm buffer for 30 min after exposure to different treatments. The mean mortality index of the sample was 0.95. The lethal concentration (LC50) was 0.11 mg·mL(-1). Cell lines were exposed to concentration of 100 µg·mL(-1) of extract for 48 h, which reduced the viability of these cell lines. The same plant extract also showed 55.58% DPPH radical scavenging activity.

Incidence of ethambutol-related visual impairment during treatment of active tuberculosis.

BACKGROUND: Recent World Health Organization guidelines recommend the addition of ethambutol (EMB) throughout standardised treatment of new cases of active tuberculosis (TB) in populations with increased prevalence of isoniazid resistance to reduce the risk of creating multidrug resistance. This could expose patients to the risk of blindness. METHODS: We searched Cochrane, Embase and PubMed electronic databases from 1965 to February 2011 for original studies that prospectively followed all patients treated with EMB for active TB, and routinely ascertained the occurrence of visual toxicity using standard methods. Pooled estimates, overall and stratified by major covariates, were calculated using random effects meta-analysis. RESULTS: Pooled cumulative incidence of any visual impairment in all patients was 22.5 per 1000 persons treated with EMB (95%CI 10.2-35), and permanent impairment was 4.3/1000 (95%CI 0.3-9.0). After restricting the analyses to arms in which the average dose was 27.5 mg/kg/day or less and treatment was for 2-9 months, the incidence of any visual impairment was 19.2/1000 (95%CI 5.8-33), and permanent impairment was 2.3/1000 persons (95%CI 0-6.1) treated, as the majority of episodes were reversible. In reversible cases, resolution of impairment occurred after an average of 3 months. CONCLUSIONS: In this review, any visual impairment occurred in 22.5/1000 persons receiving EMB at standard doses for up to 9 months, and permanent impairment in 2.3/1000-an important risk. However, these estimates are imprecise, and the studies were of variable quality and the results heterogeneous. Well-designed prospective studies with repeated measurements of multiple visual parameters that clearly describe the degree of permanent impairment are needed.

Radical scavenging and antibacterial activity of Arnebia benthamii methanol extract.

OBJECTIVE: To evaluate in vitro antioxidant and antibacterial activity of methanolic extract of Arnebia benthamii (A. benthamii) whole plant. METHODS: Plasmid damage was analyzed by agarose gell electrophoresis. Calf thymus DNA was monitored by TBARS formation. DPPH, reducing power and lipid peroxidation was evaluated by using standard procedures. Antibacterial assay was monitored by disc diffusion method. RESULTS: DPPH radical scavenging and hydroxyl radical scavenging potential of the plant revealed that the extract to be active radical scavenger. Reducing (Fe(3+)-Fe(2+)) power and lipid peroxidation inhibition efficiency (TBARS assay) of the extract was also evaluated and the extract showed promising activity in preventing lipid peroxidation and might prevent oxidative damages to biomolecules. The extract offered a significant protection against plasmid and calf thymus DNA damage induced by hydroxyl radicals. The extract was also evaluated on different bacterial strains and the maximum antibacterial activity was exhibited against Escherichia coli (E. coli) when compared with standard drug. CONCLUSIONS: These findings demonstrate that the methanol extract of A. benthamii has excellent anti-oxidant activities and could be considered as a potential source of lead molecules for pharmaceutical industries.

Long dose exposure of hydrogen peroxide (H2O2) in albino rats and effect of Podophyllum hexandrum on oxidative stress.

OBJECTIVES: The effect of Podophyllum hexandrum methanolic extract and alpha-tocopherol in reducing oxidative stress in male albino rats was evaluated. MATERIALS AND METHODS: Lipid peroxidation was monitored by measuring malondialdehyde (MDA) level in different tissues of rats. Activities of free radical scavenging enzymes (superoxide dismutase, glutathione peroxidase and catalase) were determined using H2O2 decomposition. RESULTS: Results showed that administration of H2O2 (0.1%) in drinking water of the rats, for 25 weeks, increased the malondialdehyde levels in liver, kidney and lung tissues of all the rats. However, rats receiving Podophyllum hexandrum extract and alpha-tocopherol had lower MDA levels in a dose dependent manner, which indicates decreased lipid peroxidation in these rats. Increase in the catalase activity appears to be a response to H2O2 accumulation. The decrease in the activity of catalase and increase in the activity of superoxide dismutase and glutathione peroxidase in different organs of the rats receiving Podophyllum hexandrum extract and alpha-tocopherol indicates the protective effect of the plant in combating oxidative stress undergone by the rats. OBJECTIVES: Rhizome of Podophyllum hexandrum have been ethnomedically claimed to possess a wide array of biological activities including anticancer activity. MATERIALS AND METHODS: To verify the folklore claim, this study was performed in a six Human carcinoma cell lines, Lung (A-549), Prostate (PC-3), Colon (Colo-25), Breast (MCF-7), Neuroblastoma (IMR-32) and CNS (SF-295) MCF-7 and MDA-MB-231. RESULTS: Methanol and 70% ethanolic extracts of the rhizome of Podophyllum hexandrum showed highest cytotoxic effect on MCF-7 (Breast) and Colo-25 (Colon) cell line, as determined with sulforhodamine-B (SRB) assay. CONCLUSIONS: These findings 1 - showed that Podophyllum hexandrum extract may ameliorate H2O2 induced oxidative stress by decreasing lipid peroxidation via alteration of the antioxidant defense system of the rats. 2 - these data also showed the anticancer activity of the plant extracts on different human cancer cell lines. However, further investigation is needed to assess the molecular mechanisms mediated anticancer activities of this plant.

Synthesis and antimicrobial studies of chalconyl pregnenolones.

An efficient and facile synthesis of 17-chalconyl derivatives of pregnenolone and their evaluation as antimicrobial agents against various microbial strains is reported. The scheme involves the transformation of the starting pregnenolone acetate into pregnenolone, conversion of pregnenolone to the corresponding chalcone derivatives. The compounds 3a-3j showed significant antimicrobial activity against all microbial strains used for testing.

Assessment of morphological and functional changes in neonate vitrified testis grafts after host treatment with melatonin.

This study was conducted to assess the effect of melatonin on the structure of testis and spermatogenesis dynamics in neonate vitrified testis grafts. Neonate vitrified testes, candidates for transplantation heterotopically to experiment or control groups, were warmed in thawing media which had or did not have a supplement of 100 µM melatonin, respectively. Following transplantation, melatonin (20 mg/ /kg/day) or saline solution was intraperitoneally injected into the treated and the non-treated groups, respectively. The initiating spermatogenesis, spermatogonia survival, and structure of tissue in the testis graft were examined. Cell apoptosis (TUNEL assay) and proliferation (Brdu assay) in germ cells were determined. Histological studies revealed the dynamic of the spermatogenesis process in the vitrified testis graft. However, dilation of the lumen accompanied by a disorganised epithelium in the non-treated group was higher than in the treated group. Furthermore, the proportion of apoptotic germ cells together with a reduced proportion of proliferated germ cells was higher in the non-treated group than in the treated group. Overall, the number of seminiferous tubules in the testes grafts of both groups remained steady. However, the non-treated testes grafts contained more damaged seminiferous tubules than the treated ones. The thickness of the seminiferous tubules was greater in the melatonin treated group than in the non-treated group. In fact, the thickness of germinal epithelium was significantly higher in the treated group than in the non-treated group. The study may show a positive effect from melatonin resulting in more grafts restoring puberty. Furthermore, the associated increase in the healthy number of seminiferous tubules suggests that melatonin may have a preventative ischaemia/antioxidant role and in fact may be useful to initiate the spermatogenesis process.

Seroepidemiological study of visceral leishmaniasis in Booyerahmad district, south-west Islamic Republic of Iran.

Visceral leishmaniasis (VL) is endemic in parts of Islamic Republic of Iran. A cross-sectional seroprevalence study was carried out in children in Booyerahmad district in the south-west of the country. Serum samples were taken from 1628 children up to 10 years old from different areas in Booyerahmad in 2005-06. AntiLeishmania antibody was detected in 50 out of 1628 children (3.1%) by direct agglutination test (antibody titre > or = 1:3200). There was no significant difference in seropositivity between the sexes (2.8% males and 3.3% females). The highest rate of infection (5.2%) was in the age group 10 years. Further studies are needed to explore the reservoirs and vectors of the disease in this region.

Women pose innocent victims of landmines in postwar iran.

BACKGROUND: Although in the last few years there has been an increasing attention to the problem of landmines, to date, the implications of women being victims of landmine has not been duly dealt with in the world including Iran, which is estimated to be the second most landmine infested country in the world. Still, provinces by the west border of Iran, 18 years after cessation of Iraq-Iran war suffer from the burden of vast areas, highly infested with landmines. This study aimed to provide a gender focused insight into landmine accidents in Iran METHODS: In this retrospective study, women with documented deaths or injuries due to landmine and/or unexploded ordnances (UXO) explosions as documented in their medical records between Jul 1988 (after ceasefire) and Feb 2003 were studied in 5 western provinces of Iran. Data was analyzed by SPSS for Windows Version 11. P value under 0.05 was considered statistically significant RESULTS: During the 14-year study period, 252 women from 5 western provinces of Iran were reported to have injuries or death due to landmine and UXOs. All of the victims were civilians and the majority of them (47.6%) had one or more amputations. Most of them were injured in the period between1994 and 1998. The majority of the patients were young. CONCLUSION: Women who should take care of themselves as well as their families are more prone to sufferings inflicted by landmines and UXO.

The risk factors and laboratory diagnostics for post renal transplant tuberculosis: a case-control, country-wide study on definitive cases.

BACKGROUND: Tuberculosis (TB) is an important cause of morbidity and mortality in renal transplant recipients and, because of its infrequency and the lack of medical awareness, it is usually misdiagnosed. This study was carried out to determine frequency and weight of multiple risk factors for post kidney transplantation TB. METHODS: A total of 44 cases (0.3%), out of 12,820 patients from 12 major kidney transplantation centers in Iran from 1984 to 2003, were compared with 184 healthy transplant subjects who were transplanted by the same surgical team. RESULTS: The mean age of cases and controls was 37.7 (13-63) and 35.6 (8-67) years (P=0.3), respectively. The mean duration of pre-transplantation hemodialysis was 30.3 (3-168) months in cases and 18.2 (1-180) months in controls (P=0.03). A positive past history of TB was detected in 2 cases and 1 control (P=0.3). The mean doses of initial and maintenance immunosuppressive drugs in cases and controls were not significantly different. A total of 25 cases (56.8%) and 60 controls (32.6%) had rejection before diagnosis of TB (P=0.004; OR=2.7, CI(95%): 1.3-5.6). CONCLUSIONS: To our knowledge, this is the first study that demonstrated an increase in the risk of post-transplant TB by increasing the duration of pre-transplant hemodialysis and the number of post-transplant rejection episodes as 2 immunocompromised states. Further study is needed to clarify our new findings, specifically in relation to different immunosuppressive regimens.

Effects of renal transplantation on serum-free and total PSA levels.

PURPOSE: This study was undertaken to evaluate the effects of renal transplantation on serum level of free and total PSA. MATERIALS AND METHODS: In this study, we included 30 male patients with a mean age of 46 years with end-stage renal disease undergoing renal transplantation at our department. None of the patients had any history of prostate cancer. All patients had immediate onset of renal function after transplantation, defined by a spontaneous decrease in serum creatinine on postoperative day 1 and a subsequent decrease daily during week 1. Renal transplantation included living-related donors in all patients. Blood samples were obtained before and at posttransplant day 6 before removal of Foley catheter. Measurements of free PSA and total PSA were performed with immunofluorometric assays. Glomerular filtration rates were monitored by analyzing serum creatinine. The significance of changes with time was estimated by the Wilcoxon signed ranks test for paired observations with P<.05 considered statistically significant. RESULTS: The mean free and total PSA levels before transplantation were 0.22 (range, 0.0.05 to 0.4) and 1.5 ng/mL (range, 0.1 to 2.9), respectively. There was a significant decrease (30% of original levels) in serum fPSA at posttransplant day 6 (P<.05) in all patients. There was no significant changes of total PSA at posttransplant day 6. CONCLUSIONS: These results verify the hypothesis that free PSA is eliminated from the blood circulation by glomerular filtration and severe renal failure influences its levels. Thus, we should consider different cutoffs for free to total ratio before and after renal transplantation.

Pattern of motorcycle-related injuries in Tehran, 1999 to 2000: a study in 6 hospitals.

We studied motorcycle-related injuries in Tehran from 23 August 1999 to 21 September 2000 in 6 hospitals. Data were obtained from the trauma registry and questionnaires completed by trained physicians. Of a total of 8500 patients with trauma injuries, 1332 were motorcyclists, with a male to female ratio of 15:1. Of these, 1226 patients were driving the motorcycle at the time of the accident and 75 were pillion passengers. Crashes involving another vehicle were the commonest kind of accident (72.5%). Helmet use was noted in only 8.6% of cases. There were 28 fatalities and head injuries were the prominent cause of death. Of those who died, none had been wearing a helmet at time of the crash. Only 2.7% of helmeted riders sustained a head injury, compared with 11.2% of riders without a helmet. The commonest musculoskeletal injury was fracture: tibial fracture with 509 cases (49.8%) comprised the largest proportion.

Preliminary report of a nationwide case-control study for identifying risk factors of tuberculosis following renal transplantation.

BACKGROUND: Tuberculosis (TB) is an important infection encountered posttransplantation, especially among patients in developing countries, where there are high incidences of morbidity and mortality. MATERIALS AND METHODS: One hundred and twenty subjects (1%) from 15 major kidney transplantation centers in Iran from 1984 to 2003 were compared with 440 controls who were matched for operative time, treatment center, and surgical team. RESULTS: Mean ages of research subjects and controls were 38.6 and 36.6 years (P = .04), respectively. The mean duration of pretransplantation hemodialysis was 29 months (range, 2 to 192 months) in research subjects and 20 months (range, 1 to 180 months) in controls (P = .003). Positive past history of tuberculosis was detected in 4 (3.3%) research subjects and in 7 (1.5%) controls (P = .2). Fifty-two research subjects (43.3%) and 241 controls (54.8%) had pretransplantation purified protein derivative of tuberculin less than 5 mm (P = .02). Mean dosages of initial and maintenance immunosuppressive drugs in research subjects and in controls were not significantly different. Sixty research subjects (50%) and 152 controls (34.5%) had rejection prior to diagnosis of TB (P = .03). CONCLUSION: To our knowledge, this is the first study that demonstrates an increased risk of posttransplant TB by prolonged duration of pretransplant hemodialysis and number of posttransplant rejection episodes. Further study is needed to clarify these findings specifically with respect to various immunosuppressive regimens.

Comparing Taguchi and anterior Lich-Gregoir ureterovesical reimplantation techniques for kidney transplantation.

Urologic complications are common in renal transplant surgery. Numerous innovations have been developed to circumvent ureterovesical anastomotic failure. In addition to the popular modified Lich-Gregoir technique, we evaluated Taguchi's method which is both quick and easy to perform. One hundred forty four patients were prospectively compared using Taguchi (n = 44) or the modified Lich-Gregoir (n = 100) for anastomotic time, which differed significantly (10.2 minutes for Taguchi, vs. 24.6 minutes to Lich-Gregoir; P < .005). Minor complications, however, were less among Lich-Gregoir patients (P < .02). We concluded to continue using the modified Lich-Gregoir ureteroneocystostomy despite taking longer time to perform.