Characteristics of TPT initiation and completion among people living with HIV.

BACKGROUND: TB preventive treatment (TPT) reduces morbidity and mortality among people living with HIV (PLHIV). Despite the successful scale-up of TPT in Malawi, monitoring and evaluation have been suboptimal. We utilized the Malawi Population-Based HIV Impact Assessment (MPHIA) 2020-2021 survey data to estimate TPT uptake and completion among self-reported HIV-positive persons. METHODS: We estimated the proportion of HIV-positive respondents who had ever undergone TPT, and determined the percentage of those currently on TPT who had completed more than 6 months of treatment. Bivariate and multivariable logistic regression were performed to calculate the odds ratios for factors associated with ever-taking TPT. All variables were self-reported, and the analysis was weighted and accounted for in the survey design. RESULTS: Of the HIV+ respondents, 38.8% (95% CI 36.4-41.3) had ever taken TPT. The adjusted odds of ever taking TPT were 8.0 and 5.2 times as high in the Central and Southern regions, respectively, compared to the Northern region; 1.9 times higher among those in the highest wealth quintile, and 2.1 times higher for those on antiretroviral therapy >10 years. Of those currently taking TPT, 56.2% completed >6 months of TPT. CONCLUSION: These results suggest low TPT uptake and >6 months' completion rates among self-reported HIV+ persons. Initiatives to create demand and strengthen adherence would improve TPT uptake.

CONTEXTE: Le traitement préventif de la TB (TPT) réduit la morbidité et la mortalité chez les personnes vivant avec le VIH (PVVIH). Malgré l'extension réussie du TPT au Malawi, le suivi et l'évaluation n'ont pas été optimaux. Nous avons utilisé les données de l'enquête MPHIA (Malawi Population-Based HIV Impact Assessment) 2020­2021 pour estimer l'adoption et l'achèvement du TPT parmi les personnes se déclarant séropositives. MÉTHODES: Nous avons estimé la proportion de répondants séropositifs qui avaient déjà subi un TPT et déterminé le pourcentage de ceux qui sont actuellement sous TPT et qui ont terminé plus de 6 mois de traitement. Une régression logistique bivariée et multivariable a été effectuée pour calculer les rapports de cotes des facteurs associés au fait d'avoir déjà pris un TPT. Toutes les variables étaient autodéclarées et l'analyse a été pondérée et prise en compte dans la conception de l'enquête. RÉSULTATS: Parmi les répondants séropositifs, 38,8% (IC 95% 36,4­41,3) avaient déjà pris du TPT. Les probabilités ajustées de prise de TPT étaient 8,0 et 5,2 fois plus élevées dans les régions du centre et du sud, respectivement, que dans la région du nord ; 1,9 fois plus élevées chez les personnes appartenant au quintile de richesse le plus élevé, et 2,1 fois plus élevées chez les personnes suivant une thérapie antirétrovirale depuis plus de 10 ans. Parmi ceux qui prennent actuellement un TPT, 56,2% ont terminé >6 mois de TPT. CONCLUSION: Ces résultats suggèrent un faible taux d'utilisation du TPT et des taux d'achèvement de >6 mois parmi les personnes déclarées séropositives. Des initiatives visant à créer une demande et à renforcer l'adhésion permettraient d'améliorer l'utilisation du TPT.

Clinical values of two estrogen receptor signaling targeted lncRNAs in invasive ductal breast carcinoma.

BACKGROUND: Invasive ductal carcinoma (IDC) is the most frequent type of breast cancer (BC) in women, with a high clinical burden due to its high invasive properties. Despite of quickly emerging new data regarding the molecular heterogeneity of invasive cancers, far less is known about the molecular patterns among cases of IDC. An expanding body of evidence has demonstrated that dysregulation of long noncoding RNAs (lncRNAs) is involved in the heterogeneity feature of BC. METHODS: In this study, we analyzed the expression levels of two novel lncRNAs LOC100288637 and RP11-48B3 in 51 IDC tissues in comparison with adjacent non-cancerous tissues. And finally, bio-informatic evaluation has been done. RESULTS: The results of quantitative polymerase chain reaction showed that LOC100288637 and RP11-48B3 were significantly overexpressed in tumor tissues compared to normal samples (P = 0.0085 and P = 0.0002, respectively). Also, the two lncRNAs were overexpressed in both MDA-MB-231 and MCF-7 BC cell lines, nevertheless, with a higher expression pattern in MDA-MB-231 than MCF7 cell line. Furthermore, LOC100288637 had an elevated expression level in HER-2 positive tumors compared to HER-2 negative tumors (P = 0.031). Interestingly, the lncRNA RP11-48B3.4 was upregulated in IDC subjects with the age at menarche < 14 years compared to patients with the age at menarche 14 (P = 0.041). It was observed in another result that lncRNA RP11-48B3.4 is significantly upregulated in tumors with a lower histological grade compared to tumor samples with higher grades (P = 0.047). And finally, using bio-informatic evaluation, we found a predicted interaction between RP11-48B3.4 and mRNA zinc finger and BTB domain containing 10 (ZBTB10). CONCLUSION: Altogether, our findings suggest that these lncRNAs with potential oncogenic roles are involved in the pathogenesis of IDC with clinical significance and they may therefore serve as novel markers for the dia-gnosis and treatment of IDC.

Coronavirus disease 2019 and stroke in Iran: a case series and effects on stroke admissions.

OBJECTIVE: The coronavirus disease 2019 pandemic has affected healthcare systems around the globe and massively impacted patients with various non-infectious, life-threatening conditions. Stroke is a major neurological disease contributing to death and disability worldwide, and is still an ongoing issue during the pandemic. Here we investigate the impact of the coronavirus disease 2019 outbreak on stroke manifestations, treatment courses, the outcome of stroke patients, and the hospitalization rate in a referral center for stroke management in Tehran, Iran. METHODS: We extracted data regarding 31 stroke patients (10 patients with laboratory-confirmed coronavirus disease 2019) and compared the demographic and pathological characteristics of the patients with or without coronavirus disease 2019 infection. The association of demographic/pathological characteristics of stroke patients during the coronavirus disease 2019 pandemic and a corresponding period during the previous year (49 patients) and an earlier period during the same year as the pandemic (50 patients) was also evaluated. RESULTS: The absolute number of admissions decreased about 40% during the coronavirus disease 2019 pandemic. Except for the stroke severity (P = 0.002), there were no significant changes in the demographic and pathological characteristics of the stroke patients during the three studied periods. A significantly higher mean of age (75.60 ± 9.54 versus 60.86 ± 18.45; P = 0.007), a significant difference in the type of stroke (P = 0.046), and significantly higher stroke severity (P = 0.024) were observed in stroke patients with coronavirus disease 2019 compared with those of stroke patients without coronavirus disease 2019. Treatment approaches, duration of hospitalization, and mortality rates did not differ significantly. CONCLUSIONS: This report shows that the pandemic caused the number of acute stroke admissions to plummet compared to other periods. Although the pandemic did not affect the treatment plans and care of the patients, stroke cases with coronavirus disease 2019 had higher age, more large vessel ischemic stroke, and more severe stroke. Further studies are urgently needed to realize the probable interaction of the coronavirus disease 2019 pandemic and the neurologic disease.

Anal tuberculosis: A non-Healing anal lesion.

Anal tuberculosis is an extremely rare extrapulmonary presentation of tuberculosis (TB). Less than 1% of the individuals who contract TB manifests as gastrointestinal TB, and anoperineal TB is much less frequently encountered, 1% of the TB cases of the digestive tract. A rare case of anal tuberculosis is reported in a 37-year-old male patient with a recent anal fistula surgery and relapsing anal lesions. AFB were detected by biopsy and culture. In total, the treatment course lasted 6 months and the patient showed signs of recovery in the early stages of the treatment (after 2 weeks), and complete remission was achieved. In conclusion, it is recommended that in case of encountering Non-healing and recurrent anal lesions, especially in regions endemic for TB, should be evaluated for tuberculosis.

Effect of videotape for home instruction on the quality of life of tracheostomy patients: a randomized clinical trial.

Background: Nowadays, some of the patients, such as the patients with tracheostomy are taken care of at home. The quality of life of these cases may decrease due to the appearance of changes, limitations caused by tracheostomy and improper care. Objectives: This research was performed in order to discover the effect of videotape for home instruction on the quality of life of tracheostomy cases. Patients and Procedure: A quasi-empirical research was carried out on 80 cases by a tracheotomy in Amir Elm Hospital and the Imam Khomeini Medical Center in Tehran. Patients were randomized into two teams of invasion and check through the randomized block design method. At the time of discharge and after a routine training from the clinical staff, the two groups completed a questionnaire regarding the demographic information and the sf-36 quality of life. Then, the intervention team was given a CD containing the routine training for patient care to watch at home. After two months, the participants completed the sf-36 questionnaires again, and the data were entered into SPSS version 20. The information was investigated by using the statistical tests. Findings: The statistical investigation demonstrated that the comparison between the two groups after the intervention in the overall quality of life (p = 0.003) and all the concepts included: the physical role (p = 0.02), the mental role (p = 0.01), energy and fatigue (p = 0.03), motion health (p = 0.005), social functioning (p = 0.06), disorder (p = 0. 001), common health percentage (p = 0.002) and physical functioning (p = 0.001) in the arbitration team, being higher than in the check one. Conclusion: Using the videotape education additionally to routine care has a significant effect on the improvement of the quality of life in these patients. Therefore, the use of this method is recommended as a complementary program for tracheostomy patients.

The impact of teaching psychological welfare on marital satisfaction and self-efficacy in nurses.

Objective: Proper psychological interventions for enhancing public health and mental welfare in nurses are of great importance. This study intended to explore the influence of the teaching psychological welfare on marital satisfaction and self-efficacy in nurses of Imam Khomeini hospital. Methodology: The method of the present study was semi-experimental with a pre-test post-test design and a control group. Hence, 24 nurses were selected from Imam Khomeini hospital, by using convenience sampling, and they were divided into two groups: experiment and monitoring. By using a 47-questions marital satisfaction questionnaire and a 17-questions general self-efficacy questionnaire, both groups were pre-tested. Then the test group, received lessons on psychological welfare within ten sessions, but the control group received no interventions. Afterwards, both groups were post-tested, and the data collected were analyzed by using descriptive and inferential statistics methods through SPSS software. Findings: Findings showed that teaching psychological welfare significantly increased marital satisfaction and self-efficacy in nurses (p < 0.001). Conclusion: From this research, it was concluded that teaching psychological welfare is an effective strategy for those with risky jobs like nurses, because it is highly efficient, especially when it is performed in groups, because it is cheap, and because it is acceptable by different working people.

Scheduling prioritized patients in emergency department laboratories.

This research focuses on scheduling patients in emergency department laboratories according to the priority of patients' treatments, determined by the triage factor. The objective is to minimize the total waiting time of patients in the emergency department laboratories with emphasis on patients with severe conditions. The problem is formulated as a flexible open shop scheduling problem and a mixed integer linear programming model is proposed. A genetic algorithm (GA) is developed for solving the problem. Then, the response surface methodology is applied for tuning the GA parameters. The algorithm is tested on a set of real data from an emergency department. Simulation results show that the proposed algorithm can significantly improve the efficiency of the emergency department by reducing the total waiting time of prioritized patients.

Elemental analysis of aerosols in Tehran's atmosphere using PIXE and identification of pollution sources.

In this study, the proton-induced X-ray emission (PIXE) technique has been applied to measure the elemental composition and concentrations of particulate matter of 220 samples of aerosols in Tehran's atmosphere within a 450-day time interval starting from March 2009 and ending in June 2010, covering all four seasons. PIXE analysis shows the samples are comprised of various elements including Al, Si, S, Cl, K, Ca, Ti, V, Cr, Mn, Fe, Ni, Cu, Zn, Br, Rb, Sr, and Pb. Also, to obtain more information about the sources of pollution and to identify the major sources of urban particulate matter, principal component analysis (PCA) was used. Furthermore, micro-PIXE was performed to study individual aerosols in some samples. Results revealed that the concentration of elements originating from vehicle emissions increases three times in winter; whereas the concentration of elements with soil origin remains constant. Based on wind rose maps, it is inferred that the high concentrations of the elements Al, Si, K, Ca, Ti, Mn, and Fe are associated with natural dust brought by winds into Tehran from the west.

A suppository for treating cervical erosion and its preparation method.

OBJECTIVE: To study a suppository for treating cervical erosion, its preparation method, and to observe its therapeutic effect on cervical erosion in animal models. METHODS: Twenty rats were divided into five groups: blank control group, model group, and three different therapeutic concentration groups. Phenol slurry was injected through the vagina to create cervical erosion animal models. After seven days of drug treatment, the difference of cervical histopathology was observed and compared between different groups. RESULTS: Compared with the control group, the model group showed obvious cervical erosion, inflammatory cell infiltration, vascular dilatation, and congestion. Among the administration group, the high administration group had the least inflammation and cell infiltration in the mucous membrane. CONCLUSIONS: There is a significant effect of therapeutic drugs in rats with cervical erosion, which is related to the concentration of drugs.

Radon exhalation rate and natural radionuclide content in building materials of high background areas of Ramsar, Iran.

Radon exhalation rates from building materials used in high background radiation areas (HBRA) of Ramsar were measured using an active radon gas analyzer with an emanation container. Radon exhalation rates from these samples varied from below the lower detection limit up to 384 Bq.m(-2) h(-1). The (226)Ra, (232)Th and (40)K contents were also measured using a high resolution HPGe gamma- ray spectrometer system. The activity concentration of (226)Ra, (232)Th and (40)K content varied from below the minimum detection limit up to 86,400 Bq kg(-1), 187 Bq kg(-1) and 1350 Bq kg(-1), respectively. The linear correlation coefficient between radon exhalation rate and radium concentration was 0.90. The result of this survey shows that radon exhalation rate and radium content in some local stones used as basements are extremely high and these samples are main sources of indoor radon emanation as well as external gamma radiation from uranium series.

Estimates of the occupational exposure to tenorm in the phosphoric acid production plant in Iran.

Phosphate rock is used world wide for manufacturing phosphoric acid and several chemical fertilisers. It is known that the phosphate rock contains various concentrations of uranium, thorium, radium and their daughters. The subject of this study is the evaluation of the radiation exposure to workers in the phosphoric acid production plant due to technologically enhanced naturally occurring radioactive materials that can result from the presence of naturally occurring radioactive materials in phosphate ores used in the manufacturing of phosphoric acid. Radiation exposure due to direct gamma radiation, dust inhalation and radon gas has been investigated and external and internal doses of exposed workers have been calculated. Natural radioactivity due to (40)K, (226)Ra and (232)Th have been measured in phosphate rock, phosphogypsum, chemical fertilisers and other samples by gamma spectrometry system with a high-purity germanium. The average concentrations of (226)Ra and (40)K observed in the phosphate rock are 760 and 80 Bq kg(-1), respectively. Annual effective dose from external radiation had a mean value of ∼0.673 mSv y(-1). Dust sampling revealed greatest values in the storage area. The annual average effective dose from inhalation of long-lived airborne was 0.113 mSv y(-1). Radon gas concentrations in the processing plant and storage area were found to be of the same value as the background. In this study the estimated annual effective doses to workers were below 1 mSv y(-1).

Substantivity of three concentrations of tetraclean in bovine root dentin.

In the present study, the residual antibacterial activity, or substantivity, of three concentrations of Tetraclean (Ogna Laboratori Farmaceutici, Muggiò, Italy) was assessed in bovine root dentin in vitro. One hundred ten dentin tubes prepared from bovine incisor teeth were infected in vitro for 14 days with Enterococcus faecalis. Thereafter, the specimens were divided into five groups as follows: 100% Tetraclean, 10% Tetraclean, 1% Tetraclean, sterile dentin tubes (negative control), and infected dentin tubes (positive control). Dentin chips were collected with round burs into tryptic soy broth and, after culturing, the number of colony-forming units (CFU) was counted. The number of CFU was minimal in the first cultures in all experimental groups, and the results obtained were significantly different in the different groups at all time periods (p<0.05). At all five experimental periods, the 100% Tetraclean group showed the most effective antibacterial action (p<0.05). In each group, the number of CFU increased significantly with time (p<0.05). There was a direct relationship between the concentration of Tetraclean and its substantivity. In conclusion, under the conditions of the study presented here, the substantivity of 100% Tetraclean was significantly higher than that of lower concentrations.

Glutathione-S-transferase subtypes α and π as a tool to predict and monitor graft failure or regeneration in a pilot study of living donor liver transplantation.

OBJECTIVE: Glutathione-S-transferase (GST) subtype α and π are differentially expressed in adult liver tissue. Objective of the study was if GST α and π may serve as predictive markers for liver surgery, especially transplantations. METHODS: 13 patients receiving living donor liver transplantation (LDLT) and their corresponding donors were analyzed for standard serum parameters (ALT, AST, γGT, bilirubin) as well as GST-α and -π before LDLT and daily for 10 days after LDLT. Patients (R) and donors (D) were grouped according to graft loss (R1/D1) or positive outcome (R2/D2) and above named serum parameters were compared between the groups. RESULTS: R1 showed significantly increased GST-α and significantly lower GST-π levels than R2 patients or the donors. There was a positive correlation between GST-α and ALT, AST as well as bilirubin and a negative correlation to γGT. However, γGT correlated positively with GST-π. Graft failure was associated with combined low GST-π levels in donors and their recipients before living donor liver transplantation. CONCLUSION: Our data suggest that high GST-α serum levels reflect ongoing liver damage while GST-π indicates the capacity and process of liver regeneration. Additionally, GST-π may be useful as marker for optimizing donor and recipient pairs in living donor liver transplantation.

Evaluation of occupational exposure to naturally occurring radioactive materials in the Iranian ceramics industry.

Zircon contains small amounts of uranium, thorium and radium in its crystalline structure. The ceramic industry is one of the major consumers of zirconium compounds that are used as an ingredient at ∼10-20 % by weight in glaze. In this study, seven different ceramic factories have been investigated regarding the presence of radioactive elements with focus on natural radioactivity. The overall objective of this investigation is to provide information regarding the radiation exposure to workers in the ceramic industry due to naturally occurring radioactive materials. This objective is met by collecting existing radiological data specific to glaze production and generating new data from sampling activities. The sampling effort involves the whole process of glaze production. External exposures are monitored using a portable gamma-ray spectrometer and environmental thermoluminescence dosimeters, by placing them for 6 months in some workplaces. Internal routes of exposure (mainly inhalation) are studied using air sampling, and gross alpha and beta counting. Measurement of radon gas and its progeny is performed by continuous radon gas monitors that use pulse ionisation chambers. Natural radioactivity due to the presence of ²³8U, ²³²Th and 4°K in zirconium compounds, glazes and other samples is measured by a gamma-ray spectrometry system with a high-purity germanium detector. The average concentrations of ²³8U and ²³²Th observed in the zirconium compounds are >3300 and >550 Bq kg⁻¹, respectively. The specific activities of other samples are much lower than in zirconium compounds. The annual effective dose from external radiation had a mean value of ∼0.13 mSv y⁻¹. Dust sampling revealed the greatest values in the process at the powdering site and hand weighing places. In these plants, the annual average effective dose from inhalation of long-lived airborne radionuclides was 0.226 mSv. ²²²Rn gas concentrations in the glaze production plant and storage warehouse were found to range from 10 to 213 Bq m⁻³. In this study, the estimated annual effective doses to exposed workers were <1 mSv y⁻¹.

Effect of mungbean (Vigna radiate) living mulch on density and dry weight of weeds in corn (Zea mays) field.

Living mulch is a suitable solution for weeds ecological management and is considered as an effective method in decreasing of weeds density and dry weight. In order to evaluate of mungbean living mulch effect on density and dry weight of weeds in corn field, an experiment was conducted as a split plot based on randomized complete block design with four blocks in Research Field of Department of Agronomy, Karaj Branch, Islamic Azad University in 2010. Main plots were time of mungbean suppression with 2,4-D herbicide in four levels (4, 6, 8 and 10 leaves stages of corn) and control without weeding and sub plots were densities of mungbean in three levels (50%, 100% and 150% more than optimum density). Density and dry weight of the weeds were measured in all plots with a quadrate (60 x 100 cm) in 10 days after tasseling. Totally, 9 species of weeds were identified in the field, which included 4 broad leave species that were existed in all plots. The results showed that the best time for suppression of mungbean is the 8 leaves stage of corn, which decreased density and dry weight of weeds, 53% and 51% in comparison with control, respectively. Increase of density of mungbean from 50% into 150% more than optimum density, decrease the density and dry weight of weeds, 27.5% and 22%, respectively. It is concluded that the best time and density for suppression mungbean was 8 leaves stage of corn, and 150% more than optimum density, which decreased density and dry weight of the weeds 69% and 63.5% in comparison with control, respectively.

Age and sex predict PaO2/FiO2 ratio in brain-dead donor lungs.

OBJECTIVES: To define the prevalence of various ranges of the ratio of partial arterial oxygen tension to fraction of inspired oxygen (Pao(2)/Fio(2)) and to determine correlative and predictive variables of donor lung Pao(2)/Fio(2). MATERIAL AND METHODS: From the brain death database of Masih Daneshvari Hospital Organ Procurement Center, we extracted demographic data, cause of injury, patient clinical condition, and laboratory findings as independent data. Donor lung suitability was determined with an oxygen challenge test, with results of 400 mm Hg considered ideal; 300 to 399 mm Hg, good; 200 to 299 mm Hg, borderline; and less than 200 mm Hg, not acceptable. RESULTS: Using the Pao(2)/Fio(2) cutoff points, 6.7% of donor lungs were considered ideal; 26.7%, good; 40%, borderline; and 26.7%, unacceptable. Mean (SD; range) Pao(2)/Fio(2) was 266.6 (85.6; 110-460). The Pao(2)/Fio(2) was significantly correlated with age (r = -0.35; P = .02). After entering the study variables into a linear regression model, age (-2.3; P = .008) and sex (51.5; P = .04) were significant predictors of donor lung suitability (R(2) = 0.95; P < .001). CONCLUSION: Results of oxygen challenge tests demonstrated better suitability of lungs from male and younger brain-dead donors. This finding is independent of other variables including cause of brain death and clinical and paraclinical data.

An improved estimation of daily clear-sky biologically EER from broadband global solar radiation.

To establish a relation between biologically effective erythemal radiation (EER) and global solar radiation, the hourly and daily clear-sky broadband (310-2,800 nm) global solar radiation (G) and spectral ultraviolet radiation incident on a horizontal surface at Esfahan, Iran (32 degrees 37'N, 51 degrees 40'E) were measured during the period 2001-2005. Good correlations at statistically significant levels between the daily values of EER and the daily G were found. The seasonal variability of EER/G is also discussed and the correction factors are determined for inclusion of vertical column ozone and solar zenith angle (SZA) cycles. The comparison of the estimated daily EER against the independent observed EER revealed that under clear sky conditions the estimations are accurate to 10% or better over SZA of 10-60 degrees and column ozone of 250-350 Dobson. The comparison of the results with the similar works that have used shorter period of experimental data showed more accurate estimates. The deduced relations could be used to a rough estimate of the daily EER from G in arid climate regions, where there is no measured UV radiation or there are instrumental and other difficulties encountered in measuring UV radiation.

Cultural barriers in the education of cardiovascular disease patients in Iran.

BACKGROUND: Cardiovascular diseases are responsible for the highest mortality rate in Iran; however, there is a lack of evidence for cultural factors influencing patient education. Such information is important for the provision of effective patient care. AIM: To identify key issues relating to cultural factors influencing education of cardiovascular disease patients in Iran. METHODS: The qualitative research approach was used in this study, with open-ended interviews used to gather data. Eighteen nurses, four cardiovascular specialists, nine patients with cardiovascular disease and four family members were interviewed at two educational hospitals in Tehran. Interviews were taped, transcribed and analysed using constant comparative analysis. FINDINGS: Participants expressed a range of cultural factors influencing patient education. Five themes emerged from the analysis: (a) patients' lifestyle, (b) beliefs about disease and treatment, (c) concealment of true diagnosis, (d) different opinions regarding the preferred instructor, and (e) ineffective communication. CONCLUSION: Findings show that cultural beliefs may act as risk factors for, or serve to intensify, cardiovascular disease. Consideration of these factors is essential for the success of patient education programmes.

Renal transplantation in Iran over the past two decades: a trend analysis.

BACKGROUND: In this study, we have reported updated statistics of the Iranian Transplantation Registry, the status of the recipients and grafts, and a detailed time trend with respect to patient characteristics. METHODS: We retrospectively reviewed the Iranian Renal Transplantation Registry and information from the Dialysis and Transplant Patients Public Association, to obtain data on all kidney transplantations performed in Iran between 1986 and 2005. Data were gathered regarding the total number of transplantations, graft loss, recipient death, and donor and recipient characteristics, including demographic data, cause of end-stage renal disease (ESRD), and source of kidney. We assessed changes in variables on a biannual basis. RESULTS: A total of 19521 transplantations were registered over the study period, of which, 761 recipients (3.9%) had died and 2333 allografts (11.9%) had been lost. The source of the kidney in 2556 (13%) subjects was a living related donor (LRD), in 16234 (83%) a living unrelated donor (LURD), and in 831 (4%) cadaveric. During the study decades we noted an increase in the number of kidney transplantations (from 22 to 3690), age of recipients (from 30 to 40), male-to-female ratio of recipients (from 0.58 to 0.67), male-to-female ratio of donors (from 0.48 to 0.52), diabetes mellitus (from 0% to 27%), and hypertension (from 4% to 15%), as causes of ESRD, as well as the use of cadaveric kidneys (0% to 11%). CONCLUSION: Analyzing renal transplantation data not only helps to evaluate the effectiveness of transplantation activities in a country, but also provides information to estimate future costs in the health care system.

Outcome of living kidney transplant: pediatric in comparison to adults.

BACKGROUND: Renal transplantation is the most optimal way to manage children with end-stage renal disease. Despite its benefits, pediatric renal transplantation is a challenge for several transplantation centers in terms of achieving a satisfactory outcome. We sought to compare the long-term outcome of pediatric versus adult recipients who underwent renal transplantation. METHOD: We examined, 2631 recipients of a first kidney from a living donor between 1982 and 2002. The two groups were matched for immunosuppressive therapy and number of HLA mismatches. The patients were divided into a pediatric (n=301; age 18 years) to compare 5-year patient and graft survivals. RESULTS: The mean ages of the pediatric and adult groups were 40 +/- 13 and 14 +/- 13 years, respectively. The 5-year graft survival was lower among the pediatric versus the adult group (56% vs 68%; P=.015) with no difference in patient survival (88% vs 86%; P>.05). CONCLUSION: The poorer graft survival in pediatric transplantation may be due to the nature of pediatric transplantation, in terms of inconsistent adherence to medication regimens, worse side effects of medications, higher rate of graft rejection due to recurrent disease, and more intense immunoreactivity of children.