RESUMO
BACKGROUND: The control of blood pressure (BP) is a challenge in diabetic patients and is associated with adverse outcomes of diabetes. In this systematic review and metaanalysis, we investigated the BP control rate among hypertensive diabetic patients in the Eastern Mediterranean Region (EMR) countries. METHODS: We systematically searched PubMed, Scopus, Embase, Cochrane, and Web of Science databases up to January 2023 for observational studies on BP control among hypertensive diabetic patients in all EMR countries. We included studies reporting the proportion of hypertensive, type 2 diabetic patients with controlled BP, defined as systolic/diastolic BP < 140/90 or <130/80 mmHg. Study quality was assessed using modified STROBE guidelines, and a random-effect meta-analysis was conducted to pool prevalence data and calculate overall rates. Subgroup analysis was performed by gender, study design, country, and BP control cut-offs (140/90 and 130/80). RESULTS: Among the 1949 retrieved studies, 20 studies assessing 27956 individuals were included. The proportion of BP control regardless of cut-off points was 36.8% (95% CI=29.1%45.3%) based on the studies reported for both genders.The prevalence was 53.2% (95% CI=36.1%- 69.6%) and 43.5% (95% CI=20.0%-70.3%) based on the studies reported just for women or men, respectively. CONCLUSION: Our findings indicate that BP control targets are not successfully achieved in hypertensive diabetic patients in the Eastern Mediterranean region. It is recommended to place greater emphasis on the quality of hypertension care in the management of type 2 diabetes.
RESUMO
Inattention of economic policymakers to default risk and making inappropriate decisions related to this risk in the banking system and financial institutions can have many economic, political and social consequences. In this research, it has been tried to calculate the default risk of companies listed in the capital market of Iran. To achieve this goal, two structural models of Merton and Geske, two machine learning models of Random Forest and Gradient Boosted Decision Tree, as well as financial information of companies listed in the Iranian capital market during the years 2016 to 2021 have been used. Another goal of this research is to measure the predictive power of the four models presented in the calculation of default risk. The results obtained from the calculation of the default rate of the investigated companies show that 50 companies listed in the Iranian capital market (46 different companies) have defaulted during the 5-year research period and are subject to the Bankruptcy Article of the Iranian Trade Law. Also, the results obtained from the ROC curves for the predictive power of the presented models show that the structural models of Merton and Geske have almost equal power, but the predictive power of the Random Forest model is a little more than the Gradient Boosted Decision Tree model.
Assuntos
Tomada de Decisões , Aprendizado de Máquina , Irã (Geográfico) , Algoritmo Florestas Aleatórias , Curva ROCRESUMO
Investigating the credit channel and monetary policy risk channel in Iran's economy is the aim of this article. According to empirical studies, expansionary monetary policy increases the risk of banks, and on the other hand, the risk of banks affects economic activities and price levels. In order to investigate the mechanism of the credit channel and the risk channel (as a new channel), the effect of monetary policy on real variables and price levels in Iran's economy, the Dynamic Stochastic General Equilibrium (DSGE) model has been used by entering the information of the banking system and considering moral hazard and adverse choices. The obtained results show that there is a credit channel and a monetary policy risk channel for Iran's economy, and the expansionary monetary policy shock causes output, inflation, private sector consumption, investment, net worth in the economy and lending to increase. Also, when a credit shock occurs, with the increase in banks' lending power, production, private sector consumption, investment, net worth and total lending increase and the inflation level decreases. Also, by applying the risk shock caused by the increase in inflation and the decrease in consumption and investment, the volume of lending increases and the level of production does not change much.
Assuntos
Investimentos em Saúde , Políticas , Irã (Geográfico) , InflaçãoRESUMO
Brain tumors, which are highly malignant, pose a significant threat to health and often result in substantial rates of mortality and morbidity worldwide. The brain cancer therapy has been challenging due to obstacles such as the BBB, which hinders effective delivery of therapeutic agents. Additionally, the emergence of drug resistance further complicates the management of brain tumors. TMZ is utilized in brain cancer removal, but resistance is a drawback. ncRNAs are implicated in various diseases, and their involvement in the cancer is particularly noteworthy. The focus of the current manuscript is to explore the involvement of ncRNAs in controlling drug resistance, specifically in the context of resistance to the chemotherapy drug TMZ. The review emphasizes the function of ncRNAs, particularly miRNAs, in modulating the growth and invasion of brain tumors, which significantly influences their response to TMZ treatment. Through their interactions with various molecular pathways, miRNAs are modulators of TMZ response. Similarly, lncRNAs also associate with molecular pathways and miRNAs, affecting the efficacy of TMZ chemotherapy. Given their functional properties, lncRNAs can either induce or suppress TMZ resistance in brain tumors. Furthermore, circRNAs, which are cancer controllers, regulate miRNAs by acting as sponges, thereby impacting the response to TMZ chemotherapy. The review explores the correlation between ncRNAs and TMZ chemotherapy, shedding light on the underlying molecular pathways involved in this process.
Assuntos
Neoplasias Encefálicas , Glioblastoma , MicroRNAs , RNA Longo não Codificante , Humanos , Temozolomida/farmacologia , Temozolomida/uso terapêutico , RNA Longo não Codificante/genética , Epigênese Genética , Antineoplásicos Alquilantes/farmacologia , Antineoplásicos Alquilantes/uso terapêutico , Resistencia a Medicamentos Antineoplásicos/genética , Neoplasias Encefálicas/tratamento farmacológico , Neoplasias Encefálicas/genética , Neoplasias Encefálicas/patologia , MicroRNAs/genética , MicroRNAs/uso terapêutico , Linhagem Celular Tumoral , Glioblastoma/patologiaRESUMO
Glycogen storage disease type Ib (GSDIb) is an autosomal recessive disorder caused by mutations of SLC37A4 gene, which encodes glucose 6-phosphate translocase (G6PT). Malfunction of G6PT leads to excessive fat and glycogen in liver, kidney, and intestinal mucosa. The clinical manifestations of GSD1b include hepatomegaly, renomegaly, neutropenia, hypoglycemia, and lactic acidosis. Furthermore, the disorder may result in severe complications in long-term including inflammatory bowel disease (IBD), hepatocellular adenomas (HCA), short stature, and autoimmune disorders, which stem from neutropenia and neutrophil dysfunction. Here, we represent a novel mutation of SLC37A4 in a 5-month girl who has a history of hospitalizations several times due to recurrent infection and her early presentations were failure to thrive and tachypnea. Further investigations revealed mild atrial septal defect, mild arteriovenous malformation from left lung, esophageal reflux, Horseshoe kidney, and urinary reflux in this patient. Moreover, the lab tests showed neutropenia, immunoglobulin (Ig) G and IgA deficiency, as well as thrombocytosis. Whole exome sequencing revealed c.1245G > A P.W415 homozygous mutation in SLC37A4 gene and c.580G > A p.V1941 heterozygous mutation in PIK3CD gene. This study shows that manifestations of GSD1b may not be limited to what was previously known and it should be considered in a wider range of patients.