Predictive factors of thoracic aortic calcification in patients candidate for cardiac surgery.

BACKGROUND: The presence of the severe thoracic aortic calcification (TAC) in cardiac surgery patients is associated with adverse post-operative outcome. However, the relationship between cardiovascular risk factors and aortic plaque burden remains unknown. The objective of this study was to determine the predictive factors of TAC in patients candidate for cardiac surgery. METHODS: Patients who underwent thoracic CT scan prior to cardiac surgery between August 2020 to April 2021 were included. Of 556 patients, 209 (36.7%) had a thoracic aortic calcium score (TACS) ≥ 400 mm [3] and were compare with the remaining patients. Predictors of severe TAC were assessed through stepwise multivariable logistic regression analysis. RESULTS: The patients with TACS ≥ 400 had a higher mean age (67.3 ± 7.1 vs. 55.7 ± 10.6; p < 0.001) with a higher frequency of diabetes mellitus (40.7% vs. 30.8%; p = 0.018), dyslipidemia (49.8% vs. 38.6%; p = 0.010), hypertension (60.8% vs. 44.7%; p < 0.001), opium addiction (18.2% vs. 11.2%; p = 0.023), peripheral vascular disease (PVD) (7.7% vs. 2.3%; p = 0.005) as compared with TACS < 400. The multiple determinants of TAC were PVD (OR = 2.86) followed by opium addiction, diabetes and age. CONCLUSIONS: Thoracic CT scan prior to cardiac surgery for patients with older age, diabetes, opium addiction and PVD is recommended. Our study could serve as a foundation for future research endeavors aimed at establishing a risk score for TAC.

Long-term follow-up of intravesical abobotulinumtoxinA (Dysport®) injections in women with idiopathic detrusor overactivity.

Objective: Only a few numbers of studies have been published on the use of abobotulinumtoxinA (Dysport®) in idiopathic detrusor overactivity (IDO). This study reported the long-term follow-up of women with IDO who were treated with intravesical Dysport® injections. Methods: Two hundred and thirty-six patients with IDO who had failed first-line conservative and antimuscarinic therapy received 500-900 units of Dysport® between April 2014 and July 2015. All patients were followed up for 5 years after their initial injection and interviewed on the phone. Results: A total of 236 women with IDO aged from 18 years to 84 years (mean±standard deviation: 49.6±15.9 years) were included in our study. The median follow-up time for patients was 36.5 (range: 10-70) months, and the median recovery time after injection was 18.5 (range: 0-70) months. A total of 83 (35.2%) patients stated that they had subjective improvement of their symptoms whereas 84 (35.6%) patients did not report any improvement in symptoms. The initial International Consultation on Incontinence Questionnaire Overactive Bladder mean score was 6.9 (standard deviation 3.4). There was a positive association between the median recovery time and the components of the International Consultation on Incontinence Questionnaire Overactive Bladder questionnaire. Conclusion: In a sub-population of overactive bladder patients with IDO who have failed first-line therapy, a single intravesical Dysport® injection can resolve patient symptoms completely or reduce the symptoms to an acceptable level that can be controlled with antimuscarinics or re-injection on demands.

Study on diazinon toxicity reduction by electro-Fenton process: A bioassay using daphnia magna.

The realm of diazinon reduction from polluted water has witnessed a surge in the significance of advanced oxidation processes (AOPs) in recent times. However, there is a dearth of research focusing on the mitigation of its toxicity through AOPs. Thus, the primary objective of this study was to evaluate the effectiveness of the Electro-Fenton process (EFP) in the eradication and detoxification of diazinon in aqueous solutions. Synthetic wastewater samples with concentrations of 2, 2.5 and 3 mg/L were prepared. A total of 27 samples were determined using Box Behnken Design. Reaction time, pH and iron to hydrogen peroxide ratio (Fe2+/H2O2) were examined as operational parameters under a constant current of 5.4 amps. The quantification of diazinon concentration was performed using High-Performance Liquid Chromatography (HPLC). To evaluate the detoxification of diazinon, the Daphnia magna bioassay was employed as a methodology in this study. According to the results, the EFP could reduce the diazinon to zero and the LC50 values are increased by applying the process. The LC50 values for diazinon were determined using the Daphnia magna bioassay, considering initial concentrations of 2, 2.5, and 3 mg/L at a pH of 5, a reaction time of 15 min, and an iron to hydrogen peroxide molar ratio of 2. The recorded LC50 values were 3.039, 3.076, and 3.106, respectively, indicating the lowest frequency of cumulative death in Daphnia magna. In this case, after 96 h, only 3 cases (30%) of Daphnia magna death were observed. However, for all the mentioned concentrations of diazinon, after 96 h of exposure to samples without applying the Daphnia Magna death process, it was observed between 60 and 100%. Reducing the diazinon concentration and increasing the 96-h LC50 showed that the EFP can reduce the toxicity of diazinon on Daphnia Magna at the same time. Therefore, EFP can be considered a superior method with low ecotoxicity.

Machine learning-based prediction of effluent total suspended solids in a wastewater treatment plant using different feature selection approaches: A comparative study.

Accurately predicting the characteristics of effluent, discharged from wastewater treatment plants (WWTPs) is crucial for reducing sampling requirements, labor, costs, and environmental pollution. Machine learning (ML) techniques can be effective in achieving this goal. To optimize ML-based models, various feature selection (FS) methods are employed. This study aims to investigate the impact of six FS methods (categorized as Wrapper, Filter, and Embedded methods) on the accuracy of three supervised ML algorithms in predicting total suspended solids (TSS) concentration in the effluent of a municipal wastewater treatment plant. Based on the features proposed by each FS method, five distinct scenarios were defined. Within each scenario, three ML algorithms, namely artificial neural network-multi layer perceptron (ANN-MLP), K-nearest neighbors (KNN), and adaptive boosting (AdaBoost) were applied. The features utilized for predicting TSS concentration in the WWTP effluent included BOD5, COD, TSS, TN, NH3 in the influent, and BOD5, COD, residual Cl2, NO3, TN, NH4 in the effluent. To construct the models, the dataset was randomly divided into training and testing subsets, and K-fold cross-validation was employed to control overfitting and underfitting. The evaluation metrics that are used are root mean squared error (RMSE), mean absolute error (MAE), and correlation coefficient (R2). The most efficient scenario was identified as Scenario IV, with the Sequential Backward Selection FS method. The features selected by this method were CODe, BOD5e, BOD5i, TNi. Furthermore, the ANN-MLP algorithm demonstrated the best performance, achieving the highest R2 value. This algorithm exhibited acceptable performance in both the training and testing subsets (R2 = 0.78 and R2 = 0.8, respectively).

Safety and hemostatic effect of Achillea millefolium L. in localized bleeding.

Background and Aim: This study aims to demonstrate the hemostatic effect of the hydroalcoholic extract of Achillea millefolium L. in localized bleeding and to assess the safety of its topical application on rat liver. Materials and Methods: The aerial parts of A. millefolium were macerated in methanol for two days. Twelve female Wistar rats, weighing 120-220 g, underwent anesthesia and laparotomy. The liver was exposed, and two incisions were made to induce bleeding. One incision was treated with a sponge soaked in A. millefolium extract, while the other served as a control. The animals were divided into two groups: in one, A. millefolium (150 mg/kg) was applied to the first incision, and in the other, to the second incision. Liver biopsies were collected after 4, 6, and 8 weeks. Results: Application of A. millefolium to liver incisions, whether first or second, significantly reduced bleeding time (by 36.1% and 31.9%, respectively). Histopathological analysis showed no signs of toxicity or hepatic damage after 4, 6, and 8 weeks in the female rats. Conclusion: The study confirms the hemostatic effect of the hydroalcoholic extract of A. millefolium in localized bleeding and establishes its safety for topical use.

The surveillance of plague among rodents and dogs in Western Iran.

BACKGROUND: The causative agent of plague, Yersinia pestis, is maintained in nature via a flea-rodent cycle. Western Iran is an old focus for plague, and recent data indicate that rodents and dogs in this region have serological evidence of Y. pestis infection. The purpose of this study was to conduct a large-scale investigation of Y. pestis infection in shepherd dogs, rodents, and their fleas in old foci for plague in Western Iran. MATERIALS AND METHODS: This study was conducted in Hamadan province from 2014 to 2020. Rodents and fleas were collected from various locations throughout this region. Y. pestis was investigated in rodent spleen samples and fleas using culture, serology, and real-time PCR methods. Additionally, sera samples were collected from carnivores and hares in this region, and the IgG antibody against the Y. pestis F1 antigen was assessed using an ELISA. RESULTS: In this study, 927 rodents were captured, with Meriones spp. (91.8%) and Microtus qazvinensis (2.6%) being the most prevalent. A total of 6051 fleas were collected from rodents and carnivores, most of which were isolated from Meriones persicus. None of the rodents or fleas examined tested positive for Y. pestis using real-time PCR and culture methods. Meanwhile, IgG antibodies were detected in 0.32% of rodents. All serologically positive rodents belonged to M. persicus. Furthermore, none of the sera from the 138 carnivores (129 sheepdogs, five Vulpes vulpes, four Canis aureus), and nine hares tested positive in the ELISA test. CONCLUSION: This primary survey of rodent reservoirs shows serological evidence of Y. pestis infection. Western Iran is an endemic plague focus, and as such, it requires ongoing surveillance.

Metagenomics Characterization of Ixodes ricinus Intestinal Microbiota as Major Vector of Tick-Borne Diseases in Domestic Animals.

Background: Understanding the microbiota of disease vectors can help for developing new strategies to prevent the transmission of vector pathogens. Ixodes ricinus is one of the most notorious tick vectors with increasing importance in Iran and other parts of the world while there is limited data on its microbiota. This study aimed to use metagenomics for identifying the I. ricinus tick's microbiota of Iran. Methods: A total of 39 adult ticks were collected from Mazandaran (21 females), Gilan (17 females), and Golestan (1 male). Five tick pools prepared from 39 adults of I. ricinus were subjected to metagenomics analysis. The data were analyzed by targeting the V6 region of the 16S rRNA gene by Illumina 4000 Hiseq sequencing. Results: Among hundreds of intestinal microbiota identified by metagenomics, various pathogenic microorganisms distributed in 30 genera and species including those responsible for tick-borne diseases resided in the genera Coxiella, Rickettsia, and Burkholderia were found. Conclusion: Our results indicated that metagenomics identifies bacteria genera and species which cannot be easily recognized by routine methods. The presence of such pathogenic bacteria indicates the importance of possible zoonotic diseases in this region which could affect public health. These results further substantiate the importance of advanced metagenomics analyses to identify neglected tick-borne pathogens which enable researchers to provide efficient mapping roads for the management of emerging and re-emerging infectious diseases.

Coronary Artery Bypass Graft Surgery After Primary Percutaneous Coronary Intervention in Patients With ST-Elevation Myocardial Infarction.

OBJECTIVE: To determine whether primary percutaneous coronary intervention (PPCI) is associated with adverse outcomes following coronary artery bypass graft (CABG) among patients with ST-elevation myocardial infarction (STEMI). METHODS: Patients presenting with acute STEMI who underwent CABG between September 2015 and November 2020 were included. Among 354 patients, 222 (62.7%) underwent PPCI prior to CABG (PPCI+CABG group) and were compared with the rest of the patients (CABG only group). The effects of PPCI on primary endpoints---including in-hospital mortality, length of stay (LOS), and bleeding events---were investigated using the stabilised inverse probability weighting method (S-IPW). Further, in-hospital mortality in various PPCI subgroups was analysed using univariable regression. RESULTS: Patients with and without PPCI were comparable regarding their baseline and surgical characteristics, except that those without PPCI were more likely to have left-main disease (29.5% vs 16.2%, p-value=0.003). Among the PPCI+CABG group, 3.6% mortality and 55.9% bleeding events occurred, and the LOS was 7 [5-10] days. The respective figures for the CABG only group were 4.5%, 50.8%, and 7 [6-10.5] days. Primary percutaneous coronary intervention, as a whole, was not significantly associated with either morality (S-IPW odds ratio (S-IPW OR) 0.61; p=0.393), LOS logarithm (S-IPW ß -0.050; p=0.403), or bleeding events (S-IPW OR 1.06; p=0.821). Nevertheless, the unadjusted mortality risk was significantly higher in complicated PPCIs compared with the CABG only group (OR 7.50, 95% CI 2.03-27.77); it was also higher among some other PPCI subgroups, albeit non-significantly. CONCLUSION: This study found that PPCI did not confer additional risk regarding in-hospital mortality, LOS, or bleeding among patients with acute STEMI who underwent CABG. However, some PPCI subgroups, especially those with complicated PPCI, were at increased risk.

The occurrence and distribution of microplastic contamination in Qara-sou river, Iran: incidence, quantification, and qualification.

In the current study to investigate the characte - rization of Microplastic - released into the Qara-Sou river, Kermanshah, Iran, 12 sampling sites were surveyed along a 100 km stretch of the river. The maximum and minimum numbers of MPs were about 10,000 and 45,000 items per m3. The average concentration of MPs in the Qara-sou river was 23,666 ± 12147 items per m3. The dominant size and shape of MPs ranged from 0.025 to 1 mm (~44%) and fiber shapes (~78%). In addition, SEM-EDS analyses confirmed the presence of carbon-dominant peaks with O, Ca, Fe, Al, and Si. FTIR spectra have identified some MPs in the PVC, PU, PS, PE, and nylon polymer categories. A high level of MPs was discharged into the Qara-sou river, which should be attracting the attention of the community and decision-makers to reduce damage to the environment and human health.

The Effects of Quercetin on Apoptosis and Antioxidant Activity in a Renal Ischemia/Reperfusion Injury Animal Model.

Renal ischemia-reperfusion injury (IRI) is considered as one of the most prevalent causes of acute kidney injury (AKI), which can happen in various clinical situations including hypovolemic shock, injury, thrombo-embolism, and after a kidney transplant. This paper aims to evaluate the reno-protective effects of Quercetin in induced ischemia/reperfusion injury by regulating apoptosis-related proteins, inflammatory cytokines, MMP-2, MMP-9, and nuclear factor kappa-light-chain-enhancer inactivated B cells (NF-kB) in rats. The male Wistar rats (n=32) were randomly divided into Sham, untreated IR, and Quercetin-treated IR (gavage and intraperitoneal). Quercetin was given orally and intraperitoneally one hour before inducing ischemia-reperfusion injury . After reperfusion, blood samples and kidneys were collected to assess renal function and inflammatory cytokines, apoptotic signaling proteins, and antioxidants. Urea, creatinine, and MDA levels improved in Quercetin-treated groups with different administration methods. In addition, the activities of other antioxidant in Quercetin-treated rats were higher than those in the IR group. Further, Quercetin inhibited NF-kB signaling, apoptosis-associated factors and produced matrix metalloproteinase protein in the kidneys of rats. Based on the findings, the antioxidant, anti-inflammatory, and anti-apoptotic effects of the Quercetin diminished renal ischemia-reperfusion injury in the rats significantly. It is suggested that a single dosage of Quercetin have a reno-protective impact in the case of renal I/R injury.

Serological evidence of Yersinia pestis infection in rodents and carnivores in Northwestern Iran.

BACKGROUND: Plague may recur after several decades in its endemic regions; therefore, the continuous monitoring of wildlife is essential, even when no human cases are reported in the old foci. The present study was conducted to monitor rodents and their ectoparasites as well as carnivores to learn about the epidemiology of plague infection in an old focus of Iran. METHODOLOGY: The present study was conducted from 2019 to 2020 in Takestan county of Qazvin Province in northwestern Iran. Rodents were caught using live traps, and their fleas were separated. Blood and spleen specimens were taken from the captured rodents. Serum samples were also collected from sheepdogs and wild carnivores. The collected samples were tested by culture, serology (ELISA), and molecular methods to detect Yersinia pestis infection. FINDINGS: A total of 399 small mammals were caught, of which 68.6% were Meriones persicus. A total of 2438 fleas were collected from the rodents, 95.3% of which were Xenopsylla buxtoni. Overall, 23 out of 377 tested rodents (5.7%, CI 95%, 3.9-9.0) had IgG antibodies against the F1 antigen of Y. pestis, and all the positive samples belonged to M. persicus. Nine (4.8%) out of 186 collected sera from the sheepdogs' serum and one serum from the Canis aureus had specific IgG antibodies against the F1 antigen of Y. pestis. There were no positive cases of Y. pestis in the rodents and fleas based on the culture and real-time PCR. CONCLUSION: Serological evidence of Y. pestis circulation was observed in rodents and carnivores (sheepdogs and C. aureus). The presence of potential plague vectors and serological evidence of Y. pestis infection in the surveyed animals could probably raise the risk of infection and clinical cases of plague in the studied region. Training health personnel is therefore essential to encourage their detection of possible human cases of the disease.

Hydatid cyst of papillary muscle concomitant with brain involvement.

BACKGROUND: Cardiac hydatidosis is a rare disease and the subepicardial region of the left ventricular is commonly affected. However, papillary muscle concomitant with brain involvement has not been previously reported. CASE: We report a 44 years old man who complained of headache along with no cardiac symptoms. The patient was diagnosed with cerebral hydatid cyst. Through preoperative cardiac consultant, transthoracic echocardiography revealed cardiac hydatid cyst confined to the anterolateral papillary muscle. Medical treatment was started promptly and successful surgical excision of all cysts was performed. The patient had an uneventful recovery and follow up at 3 months. CONCLUSION: Early diagnosis of cardiac HC by echocardiography is recommended in all patients with hydatid disease, regardless of HC location.

Combination of advanced nano-Fenton process and sonication for destruction of diclofenac and variables optimization using response surface method.

Diclofenac (DCF) as a non-steroidal pharmaceutical has been detected in aquatic samples more than other compounds due to its high consumption and limited biodegradability. In this study, ultrasound waves were applied along with an advanced nano-Fenton process (US/ANF) to remove DCF, and subsequently, the synergistic effect was determined. Before that, the efficiency of the US and ANF processes was separately studied. The central composite design was used as one of the most applicable responses surface method techniques to determine the main and interactive effect of the factors influencing DCF removal efficiency in US/ANF. The mean DCF removal efficiency under different operational conditions and at the time of 1-10 min was obtained to be about 4%, 83%, and 95% for the US, ANF, and US/ANF, respectively. Quadratic regression equations for two frequencies of US were developed using multiple regression analysis involving main, quadratic, and interaction effects. The optimum condition for DCF removal was obtained at time of 8.17 min, H/F of 10.5 and DCF concentration of 10.12 at 130 kHz US frequency. The synergy index values showed a slight synergistic effect for US/ANF (1.1). Although the synergistic effect of US/ANF is not very remarkable, it can be considered as a quick and efficient process for the removal of DCF from wastewater with a significant amount of mineralization.

Graphene oxide/MIL 101(Cr) (GO/MOF) nano-composite for adsorptive removal of 2,4-dichlorophenoxyacetic acid (2,4 D) from aqueous media: synthesis, characterization, kinetic and isotherm studies.

Contamination of water resources with various pollutants and therefore lack of clean water resources are major problems that threaten many human societies. The need to develop efficient methods and materials to decontaminate water resource is an undeniable fact. Metal-organic frameworks (MOFs), as new class of highly crystalline porous solids, have attracted a great deal of attention in different research fields, especially in adsorptive removal and purification. In this study, MIL 101(Cr) MOF decorated with graphene oxide nano-layers (GO/MOF) was synthesized by a simple one-pot hydrothermal method. Scanning electron microscopy (SEM), X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR) and electron dispersion energy (EDS) were utilized to approve the growing of Cr-MOF on graphene oxide nano-layer. The synthesized nano-composite was used as a potential adsorbent for the removal of a pesticide, 2, 4-dichlorophenoxyacetic acid (2,4 D). The adsorption performance, kinetic and mechanism of 2,4 D adsorption onto GO/MOF were studied. The highest adsorption capacities of 476.9 mg g-1 was obtained at room temperature, pH 6.0 using 0.6 gL-1 of GO/MOF which was 34% higher than that of pristine Cr-MOF. The kinetics and isotherm data fitted well with pseudo-second kinetic and Langmuir isotherm model, respectively. The reusability and stability analyses showed that the synthesized GO/MOF nanocomposite kept 89% of sorption capacities for 2,4 D after four adsorption-desorption cycles. GO/MOF nano-composite was successfully applied to remove 2,4 D from agricultural waste. The results approved that the synthesized nano-composite could introduce as a stable and high performance adsorbent for adsorptive removal of selected pesticide.

Spatiotemporal analysis of solar ultraviolet radiation based on Ozone Monitoring Instrument dataset in Iran, 2005-2019.

The solar ultraviolet radiation (UVR) at national, provincial and county levels in Iran during 2005-2019 were determined based on Ozone Monitoring Instrument (OMI) dataset. The temporal (annual and monthly) trends and spatial distributions of the UVR in terms of erythemally weighted daily dose (EDD), erythemally weighted irradiance at local solar noon time (EDR), and UV index and the major factors influencing the spatiotemporal trends were analyzed. The population-weighted average values of EDD, EDR, and UV index in Iran were respectively 3631 J/m2, 176.3 mW/m2, 7.1 in 2005 and rose by 0.22% per year to 3744 J/m2, 181.7 mW/m2, and 7.3, respectively in 2019, but the annual trend was not statistically significant. The EDD in Iran during the study period exhibited the highest monthly average value in June (6339 J/m2) and the lowest one in December (1263 J/m2). The solar UVA/UVB ratios at the national level during 2005-2019 were considerably lower in summer. The EDD provincial average values in the study period were in the range of 2717 (Gilan) to 4424 J/m2 (Fars). The spatiotemporal variations of the solar UVR parameters were well described by the linear models as a function of cloud optical thickness (COT), ozone column amount, surface albedo, latitude, and altitude (R2 > 0.961, p value < 0.001) and the temporal changes of the solar UVR parameters were mainly caused by the COT. The results indicated that non-burning exposure to solar UVR in summer can be more efficient for vitamin D synthesis due to higher contribution of UVB in the solar UVR. The spatial distributions and temporal trends should be considered to determine the optimal duration, time and condition of exposure to the solar UVR for the public and occupational training and public health measures.

An innovative index for assessing vulnerability of employees of different occupations from the COVID-19 pandemic in Iran.

The vulnerability of employees of different occupations from the Coronavirus disease 2019 (COVID-19) pandemic in Iran was assessed using an innovative index. The vulnerability index was developed in five steps as follows: (1) determining the principles and components of employees' susceptibility and resilience, (2) weighting the principles and components, (3) converting the levels of components to the sub-index values, (4) introducing the aggregation functions, and (5) characterizing the vulnerability index values in five categories as very high (80-100), high (65-79), medium (50-64), low (30-49), and very low (0-29). The average values of susceptibility, resilience, and vulnerability index of the employees were determined to be 35.2 ± 15.0, 73.9 ± 17.0, and 32.9 ± 12.7, respectively. The average resilience of the employees was more desirable than their average susceptibility. The distribution of the employees into the vulnerability index categories was 46.3% for very low, 41.9% for low, 3.6% for medium, and 8.2% for high. The worst cases of susceptibility and resilience principles were exposure to contaminated surfaces (59.1 ± 22.8) and top management commitment (66.6 ± 23.1). The elderly staff (especially over 50 years old), employees with low education levels, and employees in private and self-employment sectors were significantly more vulnerable (p value < 0.01) from the COVID-19 pandemic. The principles with significant incremental effects on the vulnerability index (p value < 0.05) were respectively top management commitment (+1.78), exposure to COVID-19 patients at work (+1.36), exposure to contaminated surfaces (+0.82), installing clear shields and wearing PPE (+0.59), observance of social distancing (+0.48), and just culture (+0.22). An especial plan to support the more vulnerable employees with an emphasis on the principles with the most incremental effects on the vulnerability index can efficiently control the inequality between the employees as well as occupational transmission of the COVID-19 in Iran.

COVID-19 outbreak and the impact on renal disorders: A rapid review.

In this rapid review, we aimed to evaluate the effect of coronavirus disease 2019 (COVID-19) on renal functions and mortality of patients with kidney diseases. We searched MEDLINE, The Cochrane Library, Scopus, Embase, Web of Science, UpToDate, and TRIP databases using the following keywords: COVID-19, COVID19, 2019-nCoV, 2019-CoV, coronavirus, SARS-nCoV-2, urology, cancer, bladder, prostate, kidney, trauma, stone, neurogenic, and reconstructive. The initial search resulted in 495 records. After the primary screening of titles, abstracts, and full texts and removing duplicates, 10 articles were selected and included in this rapid review. Moreover, we performed meta-analysis of binary data for the outcomes with sufficient data. Owing to a high level of heterogeneity because of different study designs and contexts, we used a random model for the meta-analysis. Only 5 studies were eligible for the meta-analysis. In these studies, comprising 964 COVID-19 positive patients, the cumulative event rate of acute kidney injury (AKI) was 7.1% (95% confidence interval: 1.8%-24.5%, p<0.001, I2=92.4). Based on the qualitative synthesis of the 10 included studies, patients with COVID-19 and kidney diseases had higher risk of in-hospital mortality. If AKI occurs because of the novel coronavirus, the mortality rate will be very high. Therefore, we need further investigations and more studies to recognize the extent and the cause of renal involvement in COVID-19.

A Survey on the Adjuvant Role of Naloxone Alone or Combined with Alum in Vaccination Against Fasciolosis in BALB/c Mice.

BACKGROUND: Fasciolosis is a zoonotic parasitic disease imposing a heavy load of livestock losses worldwide. PURPOSE: We aimed to evaluate immune-stimulatory effects of naloxone (NLX), an opioid receptor antagonist, in combination with alum in mice vaccinated with excretory-secretory antigens (E/S) of Fasciola hepatica. METHODS: 8-week-old female BALB/c mice were subcutaneously vaccinated using E/S antigens of F. hepatica. Experimental groups (14 mice per group) included: vaccine (E/S antigen), alum vaccine (E/S antigen plus alum), NLX vaccine (E/S antigen plus NLX), and alum-NLX vaccine (E/S antigen plus a mixture of alum-NLX). The control group was infused with PBS. Lymphocyte proliferation and the levels of IFN-γ, IL-4, IgG2a, IgG1, and total IgG were measured. RESULTS: Mice vaccinated with NLX or alum-NLX adjuvants showed significantly higher rates of lymphocyte proliferation, IFN-γ, total IgG, and IgG2a levels. The mice that were injected with alum showed a significantly higher concentration of IL-4. Ratios of IFN-γ/Il-4 and IgG2a/IgG1 were significantly higher in the NLX and alum-NLX groups in comparison with the groups vaccinated either with alum or without any adjuvant. A significantly higher protection rate (62.5%) was seen in mice vaccinated with the alum-NLX adjuvant compared to the other groups. CONCLUSION: NLX can be effective in conferring cellular immunity and protection against F. hepatica. It is recommended to consider this agent as a potential adjuvant in vaccines against fasciolosis.

Is it possible to preserve the blood supply of erectile organs by anastomosis using the hypogastric artery in kidney transplantation?

INTRODUCTION: Three modalities for treating chronic kidney failure are peritoneal dialysis, hemodialysis, and kidney transplantation. Among them kidney transplantation is cost-efficient and leads to a somewhat normal quality of life. In this approach, most often the external iliac artery is selected for anastomosis, but this could be disastrous if anastomosis leads to a complication. The traditional end-to-end approach for anastomosis of the kidney artery to the internal iliac artery leads to pelvic organ ischemia. However, if the end-to-end anastomosis is replaced by an end-to-side approach, it is safer. This report discusses some cases of end-to-side anastomosis using the internal iliac artery. METHOD: In ten cases of chronic kidney failure, we anastomosed the kidney artery to the internal iliac artery with an end-to-side approach. RESULTS: After vessels were unclamped, all patients had diuresis. Their creatinine was in normal range and was blood flow in the internal iliac artery, based on color Doppler ultrasound. CONCLUSION: End-to-side anastomosis can be done in some chronic kidney failure patients if their internal iliac arteries are large enough. This approach is safer than anastomosis using the external iliac artery.

Decellularization of Human Internal Mammary Artery: Biomechanical Properties and Histopathological Evaluation.

This study undertook to create small-diameter vascular grafts and assess their structure and mechanical properties to withstand arterial implantation. Twenty samples of intact human internal mammary arteries (IMAs) were collected and decellularized using detergent-based methods. To evaluate residual cellular and extracellular matrix (ECM) components, histological analysis was performed. Moreover, collagen typing and ECM structure were analyzed by Picrosirius red and Movat's pentachrome staining. Scanning electron microscopy was also applied to assess microarchitecture of both endothelial and adventitial surfaces of native and decellularized arterial samples. Furthermore, mechanical tests were performed to evaluate the rigidity and suture strength of the arteries. Human IMAs were completely decellularized in all three segments (proximal, middle, and distal). ECM proteins such as collagen and elastic fibers were efficiently preserved and no structural distortion in intima, media, and adventitial surfaces was observed. The parameters of the mechanical tests revealed no significant differences in the mechanical properties of decellularized arteries in comparison to native arteries with considerable strength, suture retention, and stress relaxation (Young's modulus [MPa] = 0.22 ± 0.023 [native] and 0.22 ± 0.015 [acellular]; and suture strength 0.56 ± 0.19 [native] vs. 0.56 ± 0.12 [acellular], respectively). Decellularized IMA represents a potential arterial scaffold as an alternative to autologous grafts for future arterial bypass surgeries. By this technique, microarchitecture and mechanical integrity of decellularized arteries were considerably similar to native arteries. The goal of this study was to introduce an efficient method for complete decellularization of human IMA and evaluate the ECM and biomechanical properties.