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Background: This study aimed to investigate the impact of child abuse and substance desire on adolescent suicide. Methods: This cross-sectional analytical study was conducted on all adolescents aged 12 to 19 who attempted suicide in 2018 at Khorshid Hospital, Isfahan, Iran. A checklist of the patients' demographic information, toxicological data, and 2 standard questionnaires, including substance desire (family, personal, social) and child abuse questionnaire (emotional abuse, physical abuse, and neglect abuse), were collected. The data were analyzed using SPSS version 15. Comparisons between the 2 groups were performed using t tests, chi-square tests, regression analysis, and crude model analysis. Odds ratio (OR) and 95% confidence interval were calculated based on logistic regression. Findings: A total of 196 teenagers were included in the study, with a mean age of 16.48 ± 1.6 years. Out of these, 155 individuals (79.1%) were female, resulting in a female-to-male ratio of 3.78. There was a significant relationship between gender and alcohol consumption in the personal aspect, as well as between the history of psychiatric diseases and alcohol consumption in the physical aspect (P < 0.005). The previous history of suicide was the only variable that showed significance in all aspects of both the substance desire and child abuse questionnaires. History of neglect abuse (OR: 1.2, 95% CI [1.07-1.41]; P = 0.009) was a predictive factor for suicide attempt. However, being male (OR: 0.12, 95% CI [0.039-0.37], P = 0.000), having no psychiatric history (OR: 0.23, 95% CI [0.10-0.52], P < 0.001) and not consuming alcohol (OR 0.33, 95% CI 0.15-0.71, P = 0.005) were identified as protective factors for attempted suicide. Conclusion: A public health strategy for suicide prevention includes implementing prevention strategies aimed at reducing risk factors, such as alcohol consumption and the risk of neglect abuse. [ABSTRACT FROM AUTHOR]

Paraquat (PQ) is a commercially important and effective herbicide in the world. Nevertheless, it has higher toxicity causing acute organ damage and different complications, mainly in the lungs and kidneys. Ferulic acid (FA), 4‐hydroxy‐3‐methoxycinnamic acid imposes multiple pharmacological impacts. No protective effect of FA on PQ poisoning‐caused human embryonic lung fibroblast damage has not been reported. Despite their many beneficial effects, FA is characterized by poor water solubility, low bioavailability, and phytochemical instability. To solve the problem, β‐cyclodextrin nanosponge (β‐CD NSs) was utilized to increase the solubility of FA so that it was grafted into β‐CD NSs to establish β‐CD@FA NSs. The purpose of this work was to examine for the first time the protective effect of β‐CD@FA NS on MRC‐5 human lung cells damages induced by PQ poisoning. MTS assay was performed to investigate the viability of MRC‐5 cells at different concentrations of FA/β‐CD@FA NSs when cells were co‐cultured with 0.2 μg/mL PQ. The flow cytometry study was carried out to determine apoptosis. Malondialdehyde (MDA), superoxide dismutase (SOD), and catalase (CAT) levels were detected using appropriate biochemistry kits. Compared with the PQ group, the cell activity, CAT, and SOD levels were significantly increased in the FA and chiefly in β‐CD@FA NSs intervention groups, whereas apoptosis and MDA levels were markedly decreased. The inflammatory factors tumor necrosis factor‐alpha (TNF‐α), interleukin 6 (IL‐6), and interleukin 22 (IL‐22) were detected. The results demonstrate that β‐CD@FA NSs can inhibit PQ‐induced cell damage by enhancing antioxidant stress capacity and regulation of inflammatory responses. [ABSTRACT FROM AUTHOR]

Backgrounds: To determine the average cutoff values of serum-free and total testosterone (FT, TT) and dehydroepiandrosterone sulfate (DHEAS) among healthy premenopausal women. Materials and Methods: Participants were women aged 18-55 years without signs and symptoms of hyperandrogenism (n = 489). Participants if Ferriman-Gallwey (FG) scores between 6 and 8 were considered a group located in the upper spectrum related to the normal hirsutism score (n = 30). DHEAS, TT, and FT levels were compared between different populations. Upper limits of 97.5 and 95 and lower limits of 5 and 2.5 percentiles were calculated to provide the reference intervals for DHEA, TT, and FT in the total sample and in the population with FG 6-8. Results: In the total population, the mean ± standard deviation (SD) serum FT, TT, and DHEAS levels were 1.40 ± 0.63 pg/mL, 0.42 ± 0.17 ng/mL, and 1.5 ± 0.97 µg/ml, respectively. The cutoff values of FT at 1.35 and TT at 0.49 were obtained for differentiating the patients with FG 6-8 scores from the normal population, with the corresponding specificity of 0.60, the sensitivity of 0.67, and area under the ROC curve (AUC) (confidence interval 95%) of 0.63 (0.52-0.73), P = 0.01 and 0.68 (0.58-0.78) P = 0.001, respectively. Conclusions: In our study, the mean ± SD serum FT level was 1.40 ± 0.63 pg/mL, the TT level was 0.42 ± 0.17 ng/mL, and the DHEAS level was 1.5 ± 0.97 µg/ml, in premenopausal women between 18 and 49 years of age. Furthermore, in a population with FG 6-8 score, a cutoff value of FT at 1.35 and TT at 0.49 was obtained. Although the irregular menstrual cycle did not change the reference range when compared with the normal group. [ABSTRACT FROM AUTHOR]

Background: Increasing incidence rates of diabetes related to air pollution have been reported in high-income countries. However, few studies evaluated air pollution effect on plasma glucose indices, in addition to diabetes and prediabetes incidence in developing countries. This study investigated the association between exposure to common air pollutants and the changes plasma glucose indices over time. The incidence of type 2 diabetes (T2D) and prediabetes in future were also examined in association with exposure to air pollution. Materials and Methods: A total of 3828 first-degree relatives of patients with T2D who were prediabetes or had normal glucose tolerance (NGT) were enrolled in this study. Cox regression was used to assess the relationships between particulate matter (PM2.5 and PM10), nitrogen monoxide (NO), nitrogen dioxide, nitric oxides, sulfur dioxide (SO2), and ozone exposure and the incidence of T2D and prediabetes. We also applied a linear mixed model to assess the association between exposure to these air pollutants and changes in plasma glucose indices over time. Results: Air pollutants showed a significant positive association with changes in fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), and 2 h oral glucose tolerance (OGTT) in participants with NGT and prediabetes. The maximum increase in plasma glucose indices was associated with NO concentration. Our study also showed exposure to all air pollutants except SO2 was significantly associated with an increased risk of developing T2D and prediabetes (Hazard ratio > 1, P < 0.001). Conclusion: According to our results, exposure to air pollution increases the risk of T2D and prediabetes incidence in our population. The exposure to air pollutants was also associated with increasing trend in FPG, HbA1c, and OGTT levels in both groups of NGT and prediabetic participants. [ABSTRACT FROM AUTHOR]

Background: There is a high prevalence of intentional paraquat poisoning especially for suicide reported from many part of the world, with its negative effects on the lungs, kidneys, heart, and digestive system. This study was planned, aimed at investigating the efficacy of sucralfate in the treatment of oral paraquat poisoning with respect to its clinical outcomes. Methods: A randomized double-blind clinical trial was conducted on 70 patients, suffering from oral paraquat poisoning. These patients were divided into two groups of 35 each. Subsequently, gastric lavage was performed for each patient in the control and treatment groups with 5 g sucralfate mixed in tap water in the treatment group, but with tap water alone in the controls. The patients' hemodynamic and laboratory parameters were evaluated and recorded, on admission and the hospital discharge dates. In addition, the patients' final clinical outcome, including survival or death was also recorded. Results: The results of the present study revealed that the patients' hemodynamic parameters, coagulation factors, renal and liver laboratory findings did not differ significantly between the two groups (P>0.05). Moreover, 45.7% and 31.4% of the patients died in the control and treatment groups, respectively (P>0.05). Conclusion: The sucralfate administration did not have a significant effect on the patients' hemodynamic and laboratory parameters. The survival of patients in the treatment group was slightly higher than those in the control group. Also the patients in the treatment group had less pulmonary and renal complications in the long-term than those in the control group. [ABSTRACT FROM AUTHOR]

Objective: Parkinson's disease (PD) is the second most common neurodegenerative disorder. Identification of PD and Parkinson-plus genes will inform us for further elucidation of the disease mechanisms and therapeutic approaches. Accordingly, in this study, an Iranian pedigree with familial PD was selected to investigate the underlying genetic causes by whole exome sequencing (WES). Methods: WES was performed on two affected family members to identify shared pathogenic putative variants. WES finding was confirmed by Sanger sequencing in two sisters. Results: Prioritizing genes related to parkinsonism identified one homozygous pathogenic mutation: g.20655C>T, c.1366C>T (p.Q456X) on the 7th exon of PINK1 gene. This homozygous C to T transition which introduces a premature termination codon (PTC) was predicted to be disease causing. Conclusion: In the present study, we report the successful application of WES to identify the molecular pathogenesis of autosomal recessive PD, which is a genetically heterogeneous disorder. The presence of this mutation in patients with family history draws attentions to the importance of genetic counseling. [ABSTRACT FROM AUTHOR]

Prolactinoma is a rare tumor of childhood. Clinical presentations of prolactinoma include amenorrhea, delayed puberty, and galactorrhea. For the first time, in this case, elevated prolactin levels were associated with unexpected premature pubarche. We describe an 8-year, 7-month-old boy with acne and gradual appearance of pubic hair, corresponding to tanner stage 2. Hormonal tests showed severe hyperprolactinemia (prolactin = 246.8 µg/L and pooled prolactin = 175 µg/L and macroprolactin = 5 µg/L) and mildly elevated level of dehdroepiandrostenedion sulfate (DHEAS) and testosterone. Magnetic resonance imaging (MRI) findings confirmed the presence of a pituitary macroprolactinoma, measuring 14 mm x 12 mm x 8 mm on the right side of the pituitary gland. Cabergoline therapy was commenced (0.5 mg/week) and after 3 months, no evidence of pubarche progression was observed. Prolactin level and tumor size markedly reduced. At the 9-month follow-up visit, a normal MRI was reported. This case highlights that even when facing premature pubarche, careful examination is mandatory, and if no obvious etiology is found for premature pubarche, clinicians should consider prolactinoma. [ABSTRACT FROM AUTHOR]

Introduction: Focal segmental glomerulosclerosis (FSGS) accounts for 20% of nephrotic syndromes among children as well as 75% of the steroid resistant nephrotic syndrome (SRNS). The aim of the present study was to evaluate the influence of parental consanguinity on clinical course and outcome of FSGS in children.Methods: This historical cohort was carried out on 69 children affected by steroid resistant FSGS. Patients' data were recorded at the initial and the final analyses and response to therapeutic measures. Subjects were also questioned about the history of parental consanguinity.Results: Forty-four participants (63.8%) were male with a male to female proportion of 1.76:1. Mean baseline age was 5.69 ± 2.39 (range: 1 to 10). Fifty-one patients (73.9%) reported consanguinity. A more significant resistance to cyclosporine A and cyclophosphamide was observed in participants denoting parental consanguinity than those with no kinship. The average renal survival time obtained significantly lower among those reporting consanguinity compared to the others (8.33 vs. 10.44 years, P < .05). According to univariate analysis results, parental consanguinity was a risk factor for developing chronic kidney disease (HR = 4.56, 95% CI: 1.06 to 19.47; P < .05).Conclusion: Patients with FSGS plus parental consanguinity presented less renal survival time with more resistance to cures being more predisposed to the development of CKD. [ABSTRACT FROM AUTHOR]

To evaluating the efficacy of fresh frozen plasma (FFP) in comparison with conventional regimen in the treatment of organophosphate (OP) poisoning. PubMed, ScopeMed, Cochrane, Scopus, and Google Scholar databases were searched. The search strategy used the following key words "organophosphate" and "poisoning or toxicity", "(atropine and oxime)", "fresh frozen plasma", "clinical trial", "outcome". The treatment with atropine or/and oxime was considered conventional therapy. The length of hospitalization, the length of ICU admission, need for mechanical ventilation and its duration, clinical recovery point, choline esterase level, mortality rate, and intermediate syndrome (IMS) occurrence were the key outcomes of interest. Databases were searched during the period of 2003–2019. Five studies were included in the analysis. Pooling of data showed that the relative risk (RR) of mortality in OP poisoning for five included trials comparing FFP-treated group with conventional regimen therapy was [0.563 (95% CI (0.252, 1.255)]. The summary of RR for IMS in two studies was [RR: 1.34, 95% CI (0.655, 2.742)]. In addition, there was a non-significant mean difference (MD) in hospital stay [MD: −0.106, 95% CI (−0.434, 0.223)] in three included trials. A significant MD was observed in the length of ICU admission in two trials between FFP-treated group compared to the conventional treatment group [MD: −2.672, 95% CI (−4.189, −1.154)], but after random effects meta-analysis, the changes were not significant [MD: −2.015, 95% CI (−6.308, 2.277)]. The summary of fixed-effect meta-analysis for choline esterase level in three trails was [MD: −0.117, 95% CI (−0.468, 0.234)]. The RR of ventilation requirement for two included trials in the FFP-treated group comparing to the conventional regimen therapy was [0.84, 95% CI (0.691, 1.022)] while for ventilation duration in two studies was [MD: −0.183, 95% CI (−0.567, 0.201)]. The addition of FFP to conventional therapy did not improve the outcomes of mortality, IMS, hospital length of stay, cholinesterase levels, need or duration of mechanical ventilation, and only the length of ICU stay could affect in the treated group. [ABSTRACT FROM AUTHOR]