Acute post sleeve surgery bleeding as rare cause of acute renal failure: a case report.

BACKGROUND: Bariatric surgeries have been considered as one of the most important treatment procedures in recent years. Being aware of the side effects of this surgery will lead to better results after the surgery. CASE PRESENTATION: A 37-year-old Iranian male patient presented one day after sleeve surgery with symptoms of weakness, lethargy, and shortness of breath, which hospitalization and workup to were done to rule out pulmonary embolism. Because of the high creatinine and anuria, we couldn't perform computed tomography angiography. A bedside ultrasound was done for the patient and showed a mild to moderate amount of fluid around the spleen and some blood clots. Due to the progressive clinical findings and suspected internal bleeding, the patient was a candidate for laparoscopic revision procedure. Gradually, after performing the surgery, removing the blood clot and reducing the compressive effect of that on the inferior verna cava which was the main reason of renal failure, the patient was able to urinate afterwards and was discharged in good general condition. CONCLUSION: Surgeons should be aware of the management of rare surgical complications after bariatric surgeries. To be best of our knowledge, this was the first case report of a patient with acute renal failure after bariatric surgery and the rare cause of clot compression on inferior vena cava and raised abdominal compartment pressure.

The protective effect of curcumin on thrombin-induced hyper-permeability.

Objective: Thrombin is a proinflammatory and pro-coagulant agent which is upregulated in several human diseases. Thrombin has a critical role in promoting cell proliferation and microvascular leakage in malignant cells, resulting in cancer growth and progression. Here, we explored the potential therapeutic value of curcumin on permeability induced by thrombin in mice. Materials and Methods: To assess the activity of curcumin on thrombin-induced vascular permeability mice model, C57BL / 6 mice were randomly divided into four groups: (1) control (2) Thrombin (3) Thrombin + Curcumin and (4) Thrombin + Metformin. Thirty minutes after treatment, Evans blue was injected intravenously through the tail vein to mice. Then, animals were sacrificed and the dye was extracted from the skin tissue by incubation with formamide. Heatmap and correlation map were generated and protein-protein interaction network of the hub genes was drawn by Cytoscape software. Results: Hub DEG expression rate showed that Heat shock protein a1 (Hspa1) family (comprised of HSPa1a, b, and HSPa5), caspase 3, and minichromosome maintenance complex component 2 were overexpressed after treatment with curcumin. Functional modules of curcumin enriched through Enrich gene biological process and revealed positive association of gene expression of apoptosis process with the therapy. Curcumin was also found to reduce leucocyte migration in murine tissues. Additionally, treatment with curcumin resulted in downregulation of heat shock proteins and proinflammatory cytokines such as monocyte chemotactic protein 1, interleukin-6 and chemokine (C-X-C motif) ligand 3. Conclusion: Curcumin inhibited the proinflammatory cytokines and inflammatory HSPs in endothelial cells and reduced thrombin-induced barrier destabilization in vivo.

Prevalence and Risk Factors of Anemia in the MASHAD Cohort Study.

BACKGROUND: Anemia is a serious public health problem which may be associated with cardiovascular diseases (CVDs) and brain damage. This survey aims to determine the prevalence of anemia and its association with demographic and biochemical factors and metabolic syndrome in a human sample derived from the MASHAD cohort study. METHODS: This survey was conducted on a sub-sample of 9847 individuals aged 35 to 65 as part of the MASHAD cohort study. Demographic characteristics and biochemical and anthropometrics indices were recorded. Data were analyzed using SPSS version 20. RESULTS: Anemia was seen in 11.5% of the population. Anemia was significantly more prevalent in younger subject (P<0.001), females (P<0.001) and those with elevated body mass index (BMI) (P<0.001). Mean high-density lipoprotein (HDL) was higher in anemic participant (P=0.032). The incidence of anemia was significantly lower in smokers (P<0.001) and also participant with hypertension (HTN) (P<0.001), diabetes mellitus (DM) (P<0.001) and metabolic syndrome (MetS) (P<0.001). Mean FBG (P<0.001), TG (P<0.001), total cholesterol (P<0.001), LDL (P<0.001) and uric acid (P<0.001) were significantly lower in anemic subjects. Cholesterol, MetS, low-density lipoprotein (LDL), BMI, uric acid, diabetes mellitus and also TG remained significantly different after multivariate analysis between anemic and healthy participants. CONCLUSION: The studied population had a lower prevalence of anemia compared to the previous WHO report for Iranians. Iron deficiency is recognized as the most important cause of anemia in Iran; however, further investigations will be need to confirm this pattern. We demonstrated that anemia is adversely associated with MetS and DM.

Transport and targeted binding of Pluronic-coated nanoparticles in unsaturated porous media.

The effectiveness of most in situ remedial technologies, including nanoremediation, lies on successful delivery of reagents to a subsurface target treatment zone. Targeted delivery of engineered nanoparticles (NPs) to treat petroleum hydrocarbons present in the unsaturated zone requires an understanding of their transport behaviour in these systems. A series of column experiments explored the effect of initial water saturation, flowrate, input dosage, and porous medium texture on the transport of iron oxide or cobalt ferrite NPs coated with an amphiphilic co-polymer, as well as their targeted attachment to a crude oil zone. As the initial water content increased with a concomitant reduction in air saturation, the degree of tailing present in the NP breakthrough curves (BTCs) reduced, and the mass of NPs recovered increased. Air saturation is positively correlated with the magnitude of air-water interfaces, which provide additional NP retention sites. At a lower injection flow rate, NP retention increased due to a longer residence time and comparatively high air saturation. NP transport behaviour was not sensitive to NP injection dose over the range tested. Increased retention and retardation of the NP BTC was observed in sediments with a higher clay and silt content. NPs coated with a lower concentration of a Pluronic block co-polymer to promote binding were preferentially retained within the crude oil zone. To simulate the asymmetrical NP breakthrough curves observed from the unsaturated systems required the use of a model that accounted for both mobile and immobile flow regions as well as NP attachment and detachment with nonlinear Langmuirian blocking. This model allowed examination of attachment and detachment rate coefficients which captured NP interaction with the porous medium and/or crude oil. It was found that the initial water saturation and flow rate did not have an appreciable impact on the NP attachment rate coefficient, while it increased by ~10× with increasing clay and silt content, and by ~100× in the presence of crude oil, indicating preferential NP attachment within the crude oil zone. As a result of the lower NP polymer concentration coating used to promote increased attachment to crude oil, higher retention was observed near the column inlet and was captured quantitatively by adding a depth-dependent straining term to the model. This retention behaviour represents a combination of irreversible attachment at the air-water interfaces and straining near the column inlet enhanced by the formation of NP aggregates. The detachment rate coefficient decreased with a lower initial water saturation and flowrate, but increased with higher clay and silt content. The findings from this study contribute to our understanding of the transport and binding behaviour of Pluronic-coated NPs in unsaturated conditions and, in particular, the role of initial water content, flowrate and porous medium texture. Demonstrated delivery of NPs to a target zone is an important step towards expanding the utility of NPs as treatment reagents.

Metformin inhibits polyphosphate-induced hyper-permeability and inflammation.

Circulating inflammatory factor inorganic polyphosphate (polyP) released from activated platelets could enhance factor XII and bradykinin resulted in increased capillary leakage and vascular permeability. PolyP induce inflammatory responses through mTOR pathway in endothelial cells, which is being reported in several diseases including atherosclerosis, thrombosis, sepsis, and cancer. Systems and molecular biology approaches were used to explore the regulatory role of the AMPK activator, metformin, on polyP-induced hyper-permeability in different organs in three different models of polyP-induced hyper-permeability including local, systemic short- and systemic long-term approaches in murine models. Our results showed that polyP disrupts endothelial barrier integrity in skin, liver, kidney, brain, heart, and lung in all three study models and metformin abrogates the disruptive effect of polyP. We also showed that activation of AMPK signaling pathway, regulation of oxidant/anti-oxidant balance, as well as decrease in inflammatory cell infiltration constitute a set of molecular mechanisms through which metformin elicits it's protective responses against polyP-induced hyper-permeability. These results support the clinical values of AMPK activators including the FDA-approved metformin in attenuating vascular damage in polyP-associated inflammatory diseases.

Hippocampal asymmetry and regional dispersal of nAChRs alpha4 and alpha7 subtypes in the adult rat.

To better comprehend the relationship between left/right (L/R) differences and hippocampus functions is necessary knowledge of lateral asymmetry and regional distribution. This research was design to examine hippocampal L/R asymmetry and regional distribution profile of the alpha7 and alpha4 subtypes of nicotinic acetylcholine receptors (nAChRs) in the adult rat. 10-12-week-old twenty-four male wistar rats were randomly selected. After removing the brains, immunohistochemistry, real-time PCR, and western blot methods were applied to distinguish the presence of the receptors in the hippocampus. Outcomes stated that the mentioned receptors expression profile was spatial-dependent. As, the hippocampal dispersal of alpha7 and alpha4 subtypes in the left hippocampus (LH) was remarkably maximum compare with the right hippocampus (RH) (p = 0.001, p = 0.005 respectively). Furthermore, the alpha7 optical density (OD) was not significantly different in the diverse regions in hippocampus of adult rat (p = 0.057), while the maximum OD of the alpha4 was detected in the hippocampal dentate gyrus and CA3 regions of LH (p = 0.007, p = 0.009 respectively) and the minimum OD was in the CA1 of the RH (p = 0.019). In real time PCR evaluation, there is a significantly higher expression of alpha7 and alpha4 in LH compared to RH (p = 0.043, p = 0.049 respectively), also, for western blot (p = 0.042, p = 0.030 respectively). According to present data, the alpha7 and alpha4 nAChR subtypes expression profile demonstrated lateral asymmetry, the uniform regional dispersal for alpha7 and different regional dispersal for alpha4 in the adult rat hippocampus.

Menstrual problems in adolescence: relationship to serum vitamins A and E, and systemic inflammation.

BACKGROUND: Vitamin status and inflammatory mechanisms may be related to menstrual cycle abnormalities. We investigated the associations between serum fat soluble vitamin (vitamins A and E) concentrations and biomarkers of inflammation and antioxidant status with menstrual characteristics, primary dysmenorrhea (PD) and premenstrual syndrome (PMS) in healthy adolescents. METHODS: A total of 897 adolescent girls either suffering from PMS (n = 134), PD (n = 322), PMS and PD (n = 293) or healthy adolescents (n = 148) were recruited. Serum vitamin A and E, high-sensitivity C-reactive protein (hs-CRP), antibody titers to Hsp27 (anti-Hsp27), serum prooxidant-antioxidant balance (PAB), WBC, mean platelet volume (MPV), and platelet distribution width (PDW) and RBC distribution width (RDW) were measured. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and RDW-to-platelet ratio (RPR) were calculated. RESULTS: Girls with long bleeding periods had lower concentrations of serum vitamin E compared to those who reported a normal period duration. There were significantly differences between the groups reporting oligomenorrhea, regular menses and polymenorrhea with respect to NLR, RPR, MPV and PDW. Logistic regression demonstrated that the presence of both PMS and PD was positively related to higher serum hs-CRP, PAB and NLR, while serum vitamin A level was inversely related to the presence of PMS. CONCLUSIONS: We found that serum vitamin A, hs-CRP, PAB and NLR are significantly associated with the presence of PMS and PD. Inflammatory processes may contribute to the etiology, symptoms and severity of menstrual disorders. Prospective studies are needed to elucidate the possibility of targeting oxidative stress and inflammatory process for the amelioration of menstrual symptoms.

Common Polymorphisms in Genes Related to Vitamin D Metabolism Affect the Response of Cognitive Abilities to Vitamin D Supplementation.

It is possible that vitamin D acts as a neurosteroid and that vitamin D deficiency may have an adverse impact on brain function and cognitive function. There are a few reports that have demonstrated an association between polymorphisms of genes involved in vitamin D metabolism and neurodegenerative disease. We aimed to evaluate the relationship between common, functional vitamin D-associated gene variants and cognitive abilities and to investigate the effect size of this polymorphism on cognitive capabilities associated with high-dose vitamin D supplementation. A total of 319 healthy adolescents received a high dose of vitamin D (50,000 IU)/week for 9 weeks. A questionnaire was used to assess cognitive abilities at baseline and after treatment. The genotypes of the CYP2R1-rs10766197 and GC-rs4588 variants were determined using TaqMan genotyping techniques. At baseline, total cognitive ability scores were higher in the AA group who were homozygous for the uncommon allele, compared with the other (AG and GG) genotypes of the CYP2R1-rs10766197 polymorphism (104.9 ± 27.8 vs. 79.1 ± 38.8 vs. 73.1 ± 25.6; p < 0.001, respectively). During the supplementation period, cognitive ability scores increased in individuals with the AG and GG genotypes, while individuals with a AA genotype did not show significant change in total score after intervention (p = 0.17). For GC SNP (rs4588), no major differences at baseline and trial-net change of cognitive tasks score were observed between the genotypes under three genetic models (pSNP = 0.67). Vitamin D supplements have trait-dependent effects on cognitive performance that suggests a causal role for vitamin D in cognitive performance. The rs10766197 variant, near the CYP2R1 gene locus, significantly modified the efficacy of high-dose vitamin D3 supplementation for its effects on improving cognitive abilities indicate that some subjects might require a higher dose to benefit from in terms of cognitive performance.

Passive smoking is associated with cognitive and emotional impairment in adolescent girls.

It is well established that smoking is associated with impaired mental health and sleep problems. However, the possible effects of passive smoking on cognitive and emotional characteristics have not previously been evaluated in adolescents. We investigated the association between passive smoking and cognitive and emotional function, and sleep patterns in 940 adolescent girls. The girls were divided into two groups [305 exposed subjects and 635 non-exposed subjects (the controls)]. The passive smokers had a significantly lower cognitive function and higher depression, aggression, and insomnia scores compared to the control group (P < 0.05). No significant difference was detected with respect to day-time sleepiness and sleep apnea. Logistic regression analyses showed that the passive smokers were more likely than the controls to have cognitive impairments, depressive mood, aggressive behavior, and insomnia. Adolescent passive smokers had significant differences in their cognitive abilities and emotional function.

Role of thrombin in the pathogenesis of atherosclerosis.

Atherosclerosis is an arterial disease associated with inflammation. Thrombin is a procoagulant and proinflammatory serine protease that contributes to the pathology of atherosclerosis by enhancing the expression of cell adhesion molecules, inducing the secretion of proinflammatory cytokines, activating inflammatory responses in atherosclerotic plaques, stimulating proliferation of aortic smooth muscle cells, and exacerbating vascular lesions at sites of injury. Hence, thrombin appears to be an important target for treatment of atherosclerosis and thrombin pharmacological inhibitors have significant therapeutic potency for suppressing inflammatory responses in cardiovascular diseases. This review summarizes the proinflammatory signaling functions of thrombin as well as the therapeutic potency of thrombin inhibitors in the pathogenesis of atherosclerosis and hence their potential therapeutic value in this condition.

The association of trace elements with premenstrual syndrome, dysmenorrhea and irritable bowel syndrome in adolescents.

OBJECTIVE: Premenstrual syndrome (PMS), primary dysmenorrhea (PD), and irritable bowel syndrome (IBS) are common complaints in women of reproductive age. Trace element status may be associated with the development of these disorders but the current data are unclear. The present study focused on the relationship between serum and dietary copper and zinc with some common physical and psychosomatic conditions among young females. STUDY DESIGN: This cross-sectional study comprised 448 adolescent girls who were classified into four groups: individuals with PMS (n = 67), PD (n = 161), both PMS and PD (n = 146), and normal (n = 74). IBS was diagnosed according to the Rome III questionnaire. Flame atomic absorption (Varian AA240FS) was used to measure serum zinc and copper. Food intake of micronutrients was estimated using a three-day dietary record. RESULTS: There was a significant difference in the frequency of IBS across the four corresponding groups as the percentage of subjects. The prevalence of IBS was significantly higher in the PD group [PMS (13.6%), PD (19.9%), both PMS and PD (17.4%) and normal (8.1%); P value < 0.05]. There was no significant differences between the mean values for serum and dietary intake of zinc and copper among four groups (p value > 0.05). Although, the mean dietary zinc intake was significantly lower in subjects with IBS (6.7 ± 2.8 mg/day) versus those without IBS (7.9 ± 3.1 mg/ day, p = 0.032). CONCLUSION: Girls with IBS were found to have significantly higher rates of gynecological symptoms, including PD and PMS. The lower dietary intake of zinc in subjects with IBS indicate a need for greater attention towards dietary patterns in these individuals.

Evaluation of HTLV-1 HBZ and proviral load, together with host IFN λ3, in pathogenesis of HAM/TSP.

Human T-cell lymphotropic virus 1 (HTLV-1) is associated with two progressive diseases: HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and adult T-cell leukemia/lymphoma (ATLL). Although HTLV-1 proviral load (PVL) has been introduced as a risk factor for these diseases' progression, it is not sufficient on its own to yield an accurate estimation of the outcome of the infection. In the present study, PVL and HTLV-1 basic leucine zipper factor (HBZ) expression level as viral factors, and IFN λ3 as a host factor, were evaluated in HAM/TSP patients and HTLV-1 asymptomatic carriers (ACs). During 2014-2015, 12 HAM/TSP patients and 18 ACs who had been referred to the HTLV-1 Clinic, Ghaem Hospital, Mashhad University of Medical Sciences (MUMS), Mashhad, Iran, were enrolled in this study. Peripheral blood mononuclear cells (PBMCs) were isolated and the DNA and mRNA were extracted for quantification of HBZ, IFN λ3 expression, and PVL using real-time PCR (TaqMan method). Although the PVL was higher in the HAM/TSP group, with a 94% confidence interval, there were no considerable differences in terms of HBZ mRNA and PVL between ACs and HAM patients. IFN λ3 expression in the HAM/TSP group was significantly higher than in the ACs (P = 0.02). To the best of our knowledge, no study has evaluated the expression level of IFN λ3 in HTLV-1 positive patients. The immune response against HTLV-1 viral antigens and virulent factors will therefore further refine our knowledge of interactions between the virus and host in the pathogenesis of HTLV-1-related disorders. The virus PVL and the host IFN λ3 can be used as pathogenic factors of HTLV-1 infected patients at risk of HAM/TSP manifestation. J. Med. Virol. 89:1102-1107, 2017. © 2016 Wiley Periodicals, Inc.

Trans-Cutaneous Bilirubinometery versus Serum Bilirubin in Neonatal Jaundice.

Hyperbilirubinemia is a common problem in neonates and causes serious complications. Thus, serial measurements of bilirubin should be done. This assessment is done through two methods of laboratory measurement in serum sample and transcutaneous bilirubinometer. This descriptive study compared transcutaneous bilirubin assessment and laboratory serum bilirubin. Bilirubin level was assessed among 256 neonates admitted to the Qods Children's Hospital in Qazvin- Iran, because of neonatal indirect jaundice, through two methods of transcutaneous bilirubinometery from two sites of forehead and sternum and laboratory measurement of bilirubin in serum. The cases were non-hemolytic icteric term neonates weighing 2500 gram or more and had not received phototherapy or other treatments. Neonates with hemolytic forms of jaundice, sepsis and suspicious to metabolic disorders were excluded. Assessments by means of KJ-8000 transcutaneous bilirubinometer from two sites of forehead and sternum and through laboratory measurement of serum bilirubin were registered and analyzed. The results of the current study showed that there was a correlation of 0.82 between serum bilirubin and transcutaneous forehead bilirubin assessment and for the used device sensitivity of 0.844; specificity of 0.842, Youden Index of 0.709 and Shortest of 0.042 for a cut-off of 12.4 in bilirubin of participants. Furthermore, Likelihood Ratio positive and negative (LR) were 5.665 and 0.164, respectively and diagnostic Odds Ratio (LR+/LR-) was 34.56. Transcutaneous bilirubinometery can be considered as a reliable tool to assess bilirubin for the screening of neonatal jaundice in term neonates.