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Sydenham's Chorea in Children with Acute Rheumatic Fever: An Echocardiographic Survey of Pediatric Patients in Northwestern Iran. 急性风湿热患儿的赛登哈姆舞蹈症:伊朗西北部儿科患者超声心动图调查。
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-01 DOI: 10.30476/ijms.2023.98738.3076
Ahmad Jamei Khosroshahi, Vida Kahani, Milad Shirvaliloo, Shahram Sadeghvand

Background: Although infrequent, Sydenham's chorea (SC) may occur as a result of injury to the basal ganglia in children with acute rheumatic fever (ARF) secondary to group A Streptococcal infection. Certain hallmarks of SC, such as movement disorders, could be utilized as a predictive marker for carditis. The present study aimed to investigate neurologic and cardiologic symptoms in children with suspected SC after ARF.

Methods: All children aged 5-16 who were admitted at Shahid Madani Pediatric Hospital (Tabriz, Iran), with an initial diagnosis of ARF and SC between 2009 and 2022 were included for echocardiographic assessment and prospective follow-up within 6 and 12 months after the start point. The pattern and severity of valvulopathy, as well as the prevalence of Jones criteria for rheumatic fever, were used to assess the effect. The collected data were analyzed using SPSS Statistics software (version 22.0) using Chi square and Fisher's exact tests. P<0.05 was considered statistically significant.

Results: The study enrolled 85 children, 36 girls and 49 boys, with a mean age of 9.7±2.7. On the first echocardiography, 42.4% of patients had mitral valve regurgitation (MR), with a predominance of female patients (P=0.04). Of those diagnosed with SC (12 girls and 6 boys), 66.7% showed cardiac involvement, with a higher prevalence of MR in both sexes (P=0.04). The pattern of cardiac involvement after 6 months was significantly different between the groups (P=0.04). However, no such difference was observed during the one-year follow-up (P=0.07). Female sex was found to have a significant relationship with SC localization (P=0.01).

Conclusion: In addition to its neurological manifestations, SC can be associated with clinical or subclinical cardiac valve dysfunction that might last for more than a year. In addition to attempting early detection and appropriate management, a precise cardiac and neurologic assessment during admission and follow-up is recommended.A preprint version of this manuscript is available at DOI: 10.21203/rs.3.rs-772662/v1 (https://www.researchsquare.com/article/rs-772662/v1).

背景:急性风湿热(ARF)患儿继发于 A 组链球菌感染后,基底节受到损伤,可能会出现叙登罕舞蹈症(SC),但这种情况并不常见。SC的某些特征,如运动障碍,可作为心脏炎的预测指标。本研究旨在调查 ARF 后疑似 SC 儿童的神经和心脏症状:方法:2009 年至 2022 年期间,伊朗大不里士市沙希德-马达尼儿科医院收治了初步诊断为 ARF 和 SC 的所有 5-16 岁儿童,对他们进行超声心动图评估,并在起始点后 6 个月和 12 个月内进行前瞻性随访。瓣膜病变的模式和严重程度以及琼斯风湿热标准的患病率用于评估效果。收集到的数据使用 SPSS 统计软件(22.0 版)进行分析,并进行了卡方检验和费雪精确检验。结果研究共招募了 85 名儿童,其中女孩 36 名,男孩 49 名,平均年龄(9.7±2.7)岁。在首次超声心动图检查中,42.4%的患者患有二尖瓣反流(MR),其中女性患者居多(P=0.04)。在确诊为二尖瓣反流的患者中(12 名女孩和 6 名男孩),66.7% 的患者心脏受累,男女患者中二尖瓣反流的发生率均较高(P=0.04)。6 个月后,两组患者的心脏受累模式有显著差异(P=0.04)。然而,在一年的随访中没有观察到这种差异(P=0.07)。女性性别与 SC 定位有明显关系(P=0.01):结论:除神经系统表现外,SC 还可能伴有临床或亚临床心脏瓣膜功能障碍,且可能持续一年以上。除了尝试早期发现和适当处理外,还建议在入院和随访期间进行精确的心脏和神经系统评估。本手稿的预印版可在以下网站获取:DOI: 10.21203/rs.3.rs-772662/v1(https://www.researchsquare.com/article/rs-772662/v1)。
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引用次数: 0
Association between Methylenetetrahydrofolate Reductase (MTHFR) and 5-Methyltetrahydrofolate-Homocysteine Methyltransferase Reductase (MTRR) Polymorphisms in Iraqi Patients with COVID-19. 伊拉克 COVID-19 患者的亚甲基四氢叶酸还原酶 (MTHFR) 和 5-甲基四氢叶酸-高半胱氨酸甲基转移酶还原酶 (MTRR) 多态性之间的关联。
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-01 DOI: 10.30476/IJMS.2023.99555.3162
Sura F Alsaffar, Noor Nihad Baqer

Background: The methylenetetrahydrofolate reductase (MTHFR) gene is an essential gene in the metabolism of folate-homocysteine. Recently, the level of homocysteine was found to be a significant marker in the follow-up of COVID-19 infection. Thus, this study aimed to detect the effect of genetic polymorphisms for single nucleotide polymorphisms (SNPs) (c.66A>G, c.1298A>C, and c.677CT) on COVID-19 infection.

Methods: Blood samples were collected from 270 patients with COVID-19 in the medical center of Al-Shifa (Baghdad, Iraq) from November 2020 to March 2021. Tetra-primer amplification refractory mutation system-polymerase chain reaction (ARMS-PCR) technique was used for the detection of genotypes of SNPs. The odds ratio (OR) was used to detect the relationship between SNPs and COVID-19 infections. Haplotype analysis was performed by SHEsis software.

Results: There was a significant difference between mild/moderate cases and severe/critical cases for ages (35-45), (46-55), and (56-65) years (P<0.0001, P=0.01, and P=0.006, respectively). The results showed significant differences in the T allele for SNP c.677>C (P<0.0001 and OR=4.58). The C allele for SNP c.1298A>C indicated significant differences (P<0.001 and OR=3.15). Besides, the G allele for SNP c.677C>T showed significant differences (P<0.001 and OR=6.64). Consequently, these SNPs showed a predisposition to the development of COVID-19 infection. With regard to the C-A-A, T-A-A and T-C-G haplotypes indicated significant differences between the control and patient groups. The C-A-A was related to a decreased risk and indicated a protective effect against COVID-19 infection development (P<0.0001 and OR=0.218). The increased risk was associated with T-A-A and T-C-G haplotypes and indicated the risk impact on COVID-19 infection development (P<0.0001, P=0.004, and OR=15.5, OR=6.772, respectively). Furthermore, the linkage disequilibrium (LD) for SNPs was studied, and the complete D' value was 99.

Conclusion: The genetic polymorphisms of SNPs (c.66A>G, c.1298A>C, and c.677C>T) in the Iraqi population were associated with COVID-19 infection.

背景:亚甲基四氢叶酸还原酶(MTHFR)基因是叶酸-同型半胱氨酸代谢过程中的重要基因。最近,研究发现同型半胱氨酸水平是 COVID-19 感染随访的一个重要标志。因此,本研究旨在检测单核苷酸多态性(SNPs)(c.66A>G、c.1298A>C 和 c.677CT)对 COVID-19 感染的影响:2020年11月至2021年3月期间,在Al-Shifa医疗中心(伊拉克巴格达)采集了270名COVID-19患者的血样。采用四引物扩增难治性突变系统聚合酶链反应(ARMS-PCR)技术检测 SNPs 的基因型。采用几率比(OR)检测 SNP 与 COVID-19 感染之间的关系。用SHEsis软件进行单倍型分析:结果:轻度/中度病例与重度/危重病例在年龄(35-45 岁)、(46-55 岁)和(56-65 岁)之间存在显著差异(PC 表明存在显著差异(PT 表明存在显著差异(PConclusion)):伊拉克人群中的 SNPs(c.66A>G、c.1298A>C 和 c.677C>T)基因多态性与 COVID-19 感染有关。
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引用次数: 0
Intra-operative Risk Factors Affecting Mortality after Heart Transplantation: A Referral Center Experience in Iran. 影响心脏移植术后死亡率的术中风险因素:伊朗转诊中心的经验
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-06-01 DOI: 10.30476/ijms.2023.99165.3122
Ali Sadeghpour Tabaei, Parham Hashemi

Background: Heart transplantation is the preferred treatment for end-stage heart failure. This study investigated the intra-operative risk factors affecting post-transplantation mortality.

Methods: This single-center retrospective cohort study examined 239 heart transplant patients over eight years, from 2011-2019, at the oldest dedicated cardiovascular center, Shahid Rajaee Hospital (Tehran, Iran). The primary evaluated clinical outcomes were rejection, readmission, and mortality one month and one year after transplantation. For data analysis, univariate logistic regression analyses were conducted.

Results: In this study, 107 patients (43.2%) were adults, and 132 patients (56.8%) were children. Notably, reoperation due to bleeding was a significant predictor of one-month mortality in both children (OR=7.47, P=0.006) and adults (OR=172.12, P<0.001). Moreover, the need for defibrillation significantly increased the risk of one-month mortality in both groups (children: OR=38.00, P<0.001; adults: OR=172.12, P<0.001). Interestingly, readmission had a protective effect against one-month mortality in both children (OR=0.02, P<0.001) and adults (OR=0.004, P<0.001). Regarding one-year mortality, the use of extracorporeal membrane oxygenation (ECMO) was associated with a higher risk in both children (OR=7.64, P=0.001) and adults (OR=12.10, P<0.001). For children, reoperation due to postoperative hemorrhage also increased the risk (OR=5.14, P=0.020), while defibrillation was a significant risk factor in both children and adults (children: OR=22.00, P<0.001; adults: OR=172.12, P<0.001). The median post-surgery survival was 22 months for children and 24 months for adults.

Conclusion: There was no correlation between sex and poorer outcomes. Mortality at one month and one year after transplantation was associated with the following risk factors: the use of ECMO, reoperation for bleeding, defibrillation following cross-clamp removal, and Intensive Care Unit (ICU) stay. Readmission, on the other hand, had a weak protective effect.

背景:心脏移植是治疗终末期心力衰竭的首选方法:心脏移植是治疗终末期心力衰竭的首选方法。本研究调查了影响移植后死亡率的术中风险因素:这项单中心回顾性队列研究对伊朗德黑兰最古老的心血管专科中心沙希德-拉贾伊医院(Shahid Rajaee Hospital,Tehran,Iran)的 239 名心脏移植患者进行了为期八年(2011-2019 年)的研究。主要评估的临床结果是移植后一个月和一年的排斥反应、再入院和死亡率。数据分析采用单变量逻辑回归分析:在这项研究中,107 名患者(43.2%)为成人,132 名患者(56.8%)为儿童。值得注意的是,因出血而再次手术是儿童(OR=7.47,P=0.006)和成人(OR=172.12,PC)一个月死亡率的重要预测因素:性别与较差的预后之间没有相关性。移植后一个月和一年的死亡率与以下风险因素有关:使用 ECMO、因出血再次手术、移除交叉钳后除颤以及重症监护室(ICU)住院。而再次入院则有微弱的保护作用。
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引用次数: 0
Pulmonary Capillary Hemangiomatosis as a Rare Underlying Cause of Primary Pulmonary Hypertension: A Case Report in an Adolescent. 肺毛细血管血管瘤病是原发性肺动脉高压的罕见病因:青少年病例报告
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-06-01 DOI: 10.30476/ijms.2024.101215.3385
Mohammad Mahdavi, Hossein Shahzadi, Mohsen Ghasemnezhad, Soheila Hoseinzadeh Moghadam

Despite its rarity, pulmonary capillary hemangiomatosis (PCH) presents a significant diagnostic challenge. Due to its similarity to other pulmonary vascular diseases, such as pulmonary veno-occlusive disease, it is characterized by abnormal pulmonary capillary proliferation, which is a rare cause of primary pulmonary hypertension. This case was the first reported instance of PCH in Shahid Rajaee Heart Hospital in Tehran, Iran, in 2023, which was confirmed by genetic testing. It highlighted the importance of considering PCH among the differential diagnoses for pulmonary hypertension, even in adolescent patients. The 13-year-old patient's main complaints were progressive exertional dyspnea and chest pain. He had no previous medical history and had not taken any pharmaceutical or herbal medications. Critical clinical findings included a heart murmur, an electrocardiogram revealing right ventricular hypertrophy, and echocardiogram evidence of pulmonary hypertension. The main diagnosis was PCH, as shown by CT findings of pulmonary artery dilatation and diffuse nodular ground glass opacities. Genetic tests indicated pathogenic EIF2AK4 mutations and suspicion of PCH. Therapeutic intervention included vasodilator therapy, which exacerbated the patient's condition. This case emphasized the importance of maintaining a high index of suspicion for rare causes of pulmonary hypertension, such as PCH. The outcome was to prepare the patient for lung transplantation. To differentiate PCH from other pulmonary vascular diseases, a combination of clinical presentation, radiologic studies, genetic analysis, and response to treatment is required to determine appropriate management, particularly lung transplantation.

肺毛细血管血管瘤病(PCH)尽管罕见,但却给诊断带来了巨大挑战。由于它与肺静脉闭塞症等其他肺血管疾病相似,其特点是肺毛细血管异常增生,是原发性肺动脉高压的罕见病因。该病例是伊朗德黑兰 Shahid Rajaee 心脏医院于 2023 年首次报告的 PCH 病例,并通过基因检测得到证实。该病例强调了在肺动脉高压的鉴别诊断中考虑 PCH 的重要性,即使是青少年患者也不例外。这名 13 岁患者的主要主诉是进行性劳力性呼吸困难和胸痛。他既往无病史,也未服用任何药物或草药。重要的临床表现包括心脏杂音、心电图显示右心室肥大以及超声心动图显示肺动脉高压。根据肺动脉扩张和弥漫性结节性磨玻璃不透明的 CT 结果,主要诊断为 PCH。基因检测显示存在致病性 EIF2AK4 突变,怀疑是 PCH。治疗干预包括血管扩张剂治疗,但却加重了患者的病情。该病例强调了对肺动脉高压等罕见病因保持高度怀疑的重要性。结果是为患者的肺移植做好了准备。要将 PCH 与其他肺血管疾病区分开来,需要结合临床表现、放射学检查、基因分析和治疗反应来确定适当的治疗方法,尤其是肺移植。
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引用次数: 0
Clinical Findings, Bacterial Agents, and Antibiotic Resistance in Children with Spontaneous Peritonitis in Southern Iran: An Academic Tertiary Referral Center's Experience. 伊朗南部自发性腹膜炎患儿的临床表现、细菌病原体和抗生素耐药性:一家学术三级转诊中心的经验。
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-06-01 DOI: 10.30476/ijms.2023.98747.3082
Sara Salehi, Naser Honar, Gholamreza Pouladfar, Marzieh Davoodi, Hamid Reihani, Mahmood Haghighat, Mohammad Hadi Imanieh, Seyed Mohsen Dehghani, Maryam Ataollahi, Narges Ansari-Charsoughi, Iraj Shahramian, Amin Abbasian

Background: Spontaneous bacterial peritonitis (SBP) is a fatal complication of ascites fluid infection. The causes of SBP in children differ from those in adults, and these bacteria are frequently resistant to antibiotics. Therefore, this study investigated the clinical findings, bacterial etiology, and antimicrobial resistance in children with SBP.

Methods: This study was conducted on all new pediatric ascites patients, who were admitted to the Department of Pediatric Gastroenterology, Namazi Hospital, affiliated with Shiraz University of Medical Sciences (Shiraz, Iran) from 2021 to 2022. Required data such as demographic information, and clinical information such as complete blood count (CBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Gram staining, blood culture by Automated Blood Culture System (BACTEC), and antibiogram of ascites fluids by disc diffusion method were all collected. Finally, the data were statistically analyzed using SPSS Software (version 26). Besides, the t test, Fisher's exact, Mann-Whitney, and Chi square tests were used for data analysis. In all tests, P≤0.05 was considered statistically significant.

Results: The present study examined 62 children with ascites of which 18 (29%) had SBP. The median (IQR) age was 2.5 (8.1) years. Thirty-four (54.8%) of the participants were girls. Abdominal pain was the most common clinical manifestation in patients (54%), and there was a significant association between abdominal pain and SBP (P=0.02). In 12 positive ascites fluid cultures, coagulase-negative staphylococci had the highest frequency (25%), followed by Escherichia coli (16.7%). Third-generation cephalosporins had a 25% sensitivity in the total positive cultures. This sensitivity was 33.3% for Gram-negative cultures and 16.6% for Gram-positive cultures.

Conclusion: Although third-generation cephalosporins are recommended as the primary antibiotic for the empirical treatment of SBP, the present study found high bacterial resistance. Finally, empirical therapy should be tailored to each region's bacterial resistance features.

背景:自发性细菌性腹膜炎(SBP自发性细菌性腹膜炎(SBP)是腹水感染的致命并发症。儿童 SBP 的病因与成人不同,而且这些细菌经常对抗生素产生耐药性。因此,本研究调查了 SBP 患儿的临床表现、细菌病因和抗菌药耐药性:本研究的对象是 2021 年至 2022 年期间在伊朗设拉子医科大学附属纳马齐医院小儿消化科住院的所有新发小儿腹水患者。研究人员收集了所需数据,如人口统计学信息,以及临床信息,如全血计数(CBC)、红细胞沉降率(ESR)、C反应蛋白(CRP)、革兰氏染色、自动血液培养系统(BACTEC)血液培养和盘式扩散法腹水液抗生素图谱。最后,使用 SPSS 软件(26 版)对数据进行统计分析。此外,数据分析还采用了 t 检验、费雪精确检验、曼-惠特尼检验和卡方检验。所有检验均以 P≤0.05 为差异有统计学意义:本研究共调查了 62 名腹水患儿,其中 18 人(29%)患有 SBP。年龄中位数(IQR)为 2.5(8.1)岁。34名(54.8%)参与者为女孩。腹痛是患者最常见的临床表现(54%),腹痛与 SBP 之间存在显著关联(P=0.02)。在 12 份阳性腹水培养液中,凝固酶阴性葡萄球菌的出现频率最高(25%),其次是大肠埃希菌(16.7%)。在所有阳性培养物中,第三代头孢菌素的敏感性为 25%。对革兰氏阴性培养物的敏感性为 33.3%,对革兰氏阳性培养物的敏感性为 16.6%:结论:尽管第三代头孢菌素被推荐为经验性治疗 SBP 的主要抗生素,但本研究发现细菌耐药性很高。最后,经验性治疗应根据每个地区的细菌耐药性特点量身定制。
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引用次数: 0
A Novel Natural Fiber Filler Reinforced Bio-Medical Polymer Composite. 新型天然纤维填充物增强生物医学聚合物复合材料
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-06-01 DOI: 10.30476/ijms.2024.99429.3148
Queen Alice Arul, Kurunji Kumaran Navaneetha Krishnan
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引用次数: 0
Congenital Adrenal Hyperplasia in Children: The Relationship between Plasma Renin Activity and Hypertension. 儿童先天性肾上腺皮质增生症:血浆肾素活性与高血压之间的关系。
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-06-01 DOI: 10.30476/ijms.2023.98508.3058
Siska Mayasari Lubis, Frida Soesanti, Eka Laksmi Hidayati, Bambang Tridjaja Aap

Background: Children with Congenital Adrenal Hyperplasia (CAH) have a higher chance of hypertension. The likelihood of hypertension is higher in CAH children who get fludrocortisone medication and have an over-suppression. Plasma renin activity (PRA) is a sensitive indicator when the fludrocortisone dose is insufficient. The objective of this study is to assess the relationship between plasma renin activity with hypertension in 21-hydroxylase-deficient (21-OHD) CAH children.

Methods: This cross-sectional observational analytical study was conducted in 2019 at the Pediatric Endocrinology Outpatient Clinic in Dr. Cipto Mangunkusumo Hospital (RSCM), Jakarta, Indonesia. The subjects were 21-OHD CAH children, aged >6 months to 18 years who had already taken hydrocortisone with or without fludrocortisone for at least 6 months, and were divided into hypertension and non-hypertension groups. The subjects were selected by a consecutive sampling method. Data was analyzed using SPSS software (version 23.0) with unpaired t test analysis and multiple logistic regression test. Statistical significance was achieved if P<0.05.

Results: Forty 21-OHD CAH patients were included, and 20 subjects (50%) had hypertension. A higher incidence of hypertension was found in salt-wasting CAH than in simple virilizing types (59.3% vs 30.8%). There was a significant mean difference in PRA levels between hypertension and non-hypertension groups in salt-wasting patients (P=0.016). A significant difference between the last dose of hydrocortisone with the number of hypertension patients in salt-wasting patients (P=0.032) was found, and low PRA levels showed a 1.09 times higher risk of hypertension.

Conclusion: Children with salt-wasting CAH with low PRA levels had a higher risk of getting hypertension.

背景:先天性肾上腺皮质增生症(CAH)患儿患高血压的几率较高。服用氟氢可的松药物并出现过度抑制的 CAH 儿童患高血压的几率更高。血浆肾素活性(PRA)是氟氢可的松剂量不足时的一个敏感指标。本研究旨在评估血浆肾素活性与 21- 羟化酶缺乏(21-OHD)CAH 儿童高血压之间的关系:这项横断面观察分析研究于 2019 年在印度尼西亚雅加达 Cipto Mangunkusumo 医生医院(RSCM)的儿科内分泌门诊进行。研究对象为21名年龄大于6个月至18岁的OHD CAH儿童,他们已服用氢化可的松或氟氢可的松至少6个月,分为高血压组和非高血压组。受试者通过连续抽样法选出。数据采用 SPSS 软件(23.0 版)进行分析,并进行非配对 t 检验分析和多元 Logistic 回归检验。如果结果有统计学意义,则为差异显著:纳入了 40 名 21-OHD CAH 患者,其中 20 人(50%)患有高血压。盐耗竭型 CAH 的高血压发病率高于单纯男性化型(59.3% 对 30.8%)。在盐耗竭型患者中,高血压组和非高血压组的 PRA 水平均值差异明显(P=0.016)。最后一次服用氢化可的松的剂量与盐耗竭患者中高血压患者的数量之间存在明显差异(P=0.032),PRA水平低的患者患高血压的风险比PRA水平高1.09倍:结论:PRA水平低的盐耗竭型CAH患儿患高血压的风险较高。
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引用次数: 0
Modalization and Transcendence of Health in the Coming Decade: Emphasizing the Human Cognitive System in the Stories of Prophets in the Holy Quran. 未来十年健康的模式化与超越:强调《古兰经》先知故事中的人类认知系统。
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-06-01 DOI: 10.30476/ijms.2024.100885.3344
Seyed Ziaeddin Tabei, Fatemeh Khiveh, Sedigheh Ebrahimi

In this study, the progression and importance of health knowledge is explored, projecting its future path. We do this by comparing the stages of evolution of the human cognitive system from birth to old age (inner intellect) with the stages of intellectual modalization in divine messengers (external intellect), as depicted in the stories of the prophets in the Holy Quran. This comparison aims to articulate the course of evolution, which includes sensory perception, apprehension, imaginalization, intellection, and intuition. Future medicine will consider the influence of spiritual factors (soul) in the form of human cognition and intention, as well as material effects (genes and biology). The seven medical domains of the future will encompass the field of 'sprito-epigenetico psycho-neuro-endocrino-immuno-pharmacology'. This perspective emphasizes the need for a transcendent outlook in health and medicine. This study employed a library research method, including studies in medical journals from the last forty years.

本研究探讨了健康知识的发展和重要性,并预测了其未来的发展道路。为此,我们将人类认知系统从出生到老年的进化阶段(内在智力)与《古兰经》中先知故事所描述的神圣使者的智力模式化阶段(外在智力)进行了比较。这种比较旨在阐明进化的过程,其中包括感官知觉、理解、想象、思考和直觉。未来医学将考虑以人类认知和意图为形式的精神因素(灵魂)以及物质效应(基因和生物)的影响。未来的七大医学领域将包括 "精神-表观遗传学-心理-神经-内分泌-免疫-药理学"。这一观点强调了健康和医学需要有一种超越的视角。本研究采用图书馆研究方法,包括对过去四十年医学期刊的研究。
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引用次数: 0
Exchange Transfusion Trends and Risk Factors for Extreme Neonatal Hyperbilirubinemia over 10 Years in Shiraz, Iran. 伊朗设拉子 10 年间新生儿极端高胆红素血症的交换输血趋势和风险因素。
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-06-01 DOI: 10.30476/ijms.2023.99176.3123
Fariba Hemmati, Seyed Moein Mahini, Mehrnoosh Bushehri, Amir Hossein Asadi, Hamide Barzegar

Background: Exchange transfusion (ET) is an effective treatment for acute bilirubin encephalopathy and extreme neonatal hyperbilirubinemia (ENH). It can reduce mortality and morbidity. This study aimed to investigate the trends and risk factors of ENH requiring ET in hospitalized neonates in Iran.

Methods: A retrospective analysis of medical records of neonates who underwent ET due to ENH was conducted from 2011 to 2021, in Shiraz, Iran. Clinical records were used to gather demographic and laboratory data. The quantitative data were expressed as mean±SD, and qualitative data was presented as frequency and percentage. P<0.05 was considered statistically significant.

Results: During the study, 377 ETs were performed for 329 patients. The annual rate of ET decreased by 71.2% during the study period. The most common risk factor of ENH was glucose-6-phosphate dehydrogenase (G6PD) deficiency (35%), followed by prematurity (13.06%), ABO hemolytic disease (7.6%), sepsis (6.4%), Rh hemolytic disease (6.08%), and minor blood group incompatibility (3.34%). In 28.52% of the cases, the cause of ENH was not identified. 17 (5.1%) neonates had acute bilirubin encephalopathy, of whom 6 (35.29%) had G6PD deficiency, 6 (35.29%) had ABO incompatibility, and 2 (11.76%) had Rh incompatibility.

Conclusion: Although the rate of ET occurrence has decreased, it seems necessary to consider different risk factors and appropriate guidelines for early identification and management of neonates at risk of ENH should be developed. The findings of the study highlighted the important risk factors of ENH in southern Iran, allowing for the development of appropriate prevention strategies.

背景:交换输血(ET)是治疗急性胆红素脑病和新生儿极度高胆红素血症(ENH)的有效方法。它可以降低死亡率和发病率。本研究旨在调查伊朗住院新生儿需要进行 ET 的 ENH 的趋势和风险因素:方法:2011 年至 2021 年期间,在伊朗设拉子对因 ENH 而接受 ET 的新生儿病历进行了回顾性分析。临床记录用于收集人口统计学和实验室数据。定量数据以均数±SD表示,定性数据以频率和百分比表示。结果:研究期间,为 329 名患者进行了 377 次 ET。在研究期间,每年的 ET 率下降了 71.2%。ENH最常见的风险因素是葡萄糖-6-磷酸脱氢酶(G6PD)缺乏症(35%),其次是早产儿(13.06%)、ABO溶血病(7.6%)、败血症(6.4%)、Rh溶血病(6.08%)和小血型不合(3.34%)。28.52%的病例未找到导致 ENH 的原因。17名(5.1%)新生儿患有急性胆红素脑病,其中6名(35.29%)患有G6PD缺乏症,6名(35.29%)患有ABO血型不合,2名(11.76%)患有Rh血型不合:尽管ET发生率有所下降,但似乎仍有必要考虑不同的风险因素,并应制定适当的指南,以便及早识别和管理有ENH风险的新生儿。研究结果突显了伊朗南部 ENH 的重要风险因素,有助于制定适当的预防策略。
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引用次数: 0
The Comparison of Irisin, Subfatin, and Adropin in Normal-Weight and Obese Polycystic Ovary Syndrome Patients. 正常体重和肥胖多囊卵巢综合征患者体内鸢尾素、亚脂肪素和阿托品的比较。
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-06-01 DOI: 10.30476/ijms.2023.99130.3117
Alabbas Abdulkareem Majeed, Alaa Hussein J Al-Qaisi, Waled Abdo Ahmed

Background: A combination of genetic and environmental factors contribute to the highly common, complex, and varied endocrine condition known as polycystic ovary syndrome (PCOS) in women. PCOS primarily affects women between the ages of 15 and 35 who are in the early to late stages of pregnancy. Thus, this study aimed to evaluate the serum levels of irisin, subfatin, and adropin in PCOS with and without obesity compared to the control group.

Methods: The present cross-sectional study was conducted in 2022 at Al-Nahrain University/Department of Chemistry (Baghdad, Iraq). The serum levels of irisin, subfatin, and adropin were measured with the enzyme-linked immunosorbent assay (ELISA) method. Body mass index, lipid profile, insulin, fasting glucose, follicle-stimulating hormone, and luteinizing hormone levels were also evaluated. The data were analyzed using one-way analysis of variance (ANOVA) by GraphPad Prism software version 8.0.2. A P<0.05 was considered statistically significant.

Results: The study population comprised PCOS patients (n=90, divided into 45 obese and 45 normal weight) and healthy women (n=30). According to the results, the serum levels of irisin were significantly higher (P<0.001) in obese and normal-weight PCOS patients than controls. While adropin and subfatin were significantly lower in PCOS than controls (P<0.001). Moreover, there are higher levels of serum insulin, fasting glucose, and luteinizing hormone in PCOS women than in healthy women.

Conclusion: According to the findings, PCOS patients had a higher level of irisin than the controls. In addition, decreased subfatin and adropin levels were observed in PCOS patients compared with healthy women. Further research is required to confirm these results in the future.

背景:女性多囊卵巢综合征(PCOS)是一种非常常见、复杂多变的内分泌疾病,由遗传和环境因素共同作用所致。多囊卵巢综合征主要影响年龄在 15 至 35 岁之间、处于孕早期至孕晚期的女性。因此,本研究旨在评估与对照组相比,多囊卵巢综合征患者血清中鸢尾素、亚脂肪素和阿托品的水平:本横断面研究于 2022 年在 Al-Nahrain 大学化学系(伊拉克巴格达)进行。采用酶联免疫吸附试验(ELISA)法测定血清中鸢尾素、亚脂肪素和阿托品的水平。此外,还对体重指数、血脂、胰岛素、空腹血糖、卵泡刺激素和黄体生成素水平进行了评估。使用 GraphPad Prism 软件 8.0.2 版对数据进行单因素方差分析(ANOVA)。结果研究对象包括多囊卵巢综合征患者(90 人,其中肥胖 45 人,体重正常 45 人)和健康女性(30 人)。结果显示,血清中鸢尾素的水平明显较高(多囊卵巢综合征):根据研究结果,多囊卵巢综合症患者的鸢尾素水平高于对照组。此外,与健康女性相比,多囊卵巢综合症患者的亚脂肪素和阿托品水平也有所下降。今后还需要进一步的研究来证实这些结果。
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引用次数: 0
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Iranian Journal of Medical Sciences
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