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Objective: This study was designed to use sonography and evaluate arteriovenous fistulas (AVFs) in dialysis patients. The aim was to determine criteria for distinguishing between patent AVFs with proper function (healthy) and unhealthy AVFs. Materials and Methods: This study enrolled 106 dialysis patients with an AVF. All fistulas were evaluated using spectral Doppler and grayscale sonography, assessing parameters such as draining vein diameter, distance of the venous vein from the skin surface, feeding artery diameter, presence of thrombosis, and fistula stenosis. Subsequently, Doppler criteria such as flow volume (FV) and resistance index (RI) were measured and compared between healthy and unhealthy AVFs. Results: This cohort's spectral Doppler findings demonstrated lower FV and higher RI, in unhealthy AVFs, compared to healthy ones (283.5 ± 101.26 mL/min vs 1383.43 ± 756.76 mL/min; P =.006) and (0.55 ± 0.33 vs 0.37 ± 0.14; P =.004) respectively. Conclusion: The spectral Doppler and grayscale sonographic imaging made it possible to evaluate AVF performance and determine its quality. In this cohort, a decreased FV, increased RI, and decreased draining vein diameter were observed in unhealthy AVFs. These results would suggest that sonographers and clinicians should pay close attention to these parameters when assessing the function of an AVF, for patients undergoing hemodialysis. [ABSTRACT FROM AUTHOR]

Introduction: Posterior urethral injuries in men commonly occur following pelvic and perineal trauma. Erectile dysfunction (ED), whether brought on by the severity of the initial trauma or the surgery itself, is one of the complications in these patients. Materials and methods: In this study, we divided candidates of posterior urethroplasty due to traumatic urethral injury into intervention and placebo groups; the former received continuous treatment with tadalafil (10 mg daily), and the latter received a placebo. Other services were provided equally to both groups. Before and after the intervention, both groups completed the International Index of Erectile Function version 5 (IIEF-5) questionnaire, and the findings were analyzed. Results: Forty patients were studied in groups of 20 with a mean age of 43.87 ± 15.70 years. The patient's most common cause of urethral injury was a pelvic fracture. Before the intervention, the mean scores of IIEF for patients in the intervention group and placebo group were 14.85 ± 7.39 and 14.77 ± 6.48, respectively with no statistical significance (p = 0.962) and patients of the groups were similar in terms of the severity of ED. The mean IIEF score in the intervention group was 20.12 ± 4.94 and in the placebo group, it was 18.05 ± 4.88 at the three-month follow-up, with no statistically significant difference (p = 0.063). In both the intervention and placebo groups, the IIEF score was significantly increased by 5.27 ± 4.04 (p < 0.001) and 3.27 ± 2.97 (p < 0.001), respectively. The rate of IIEF increase in the intervention group was higher than in the placebo group during the follow-up at 3-month follow-up with statistical significance. (p = 0.022). Conclusion: The findings of this study suggest that tadalafil, in a 3-month treatment course, may improve erectile function in individuals with mild-to-moderate ED, significantly more than placebo. However, more studies, specifically with longer duration of follow-up and larger populations, are necessary for generalizing the current findings. [ABSTRACT FROM AUTHOR]

Objectives: Lung cancer is the most prevalent cancer in the world and one of the five most common cancers in Iran. The level of Ki67 biomarker is related to any of the factors affecting the grading of neuroendocrine lung tumors, which is used as one of the grading criteria and a criterion for assessing and predicting survival and prognostic factors. The aim of this study was to investigate the relationship between Ki67 antigen incidence and mitotic count, necrosis, tumor size in the neuroendocrine tumors of the lung. Materials and Methods: The samples of this analytical descriptive study, including the neuroendocrine tumors of the lung in paraffin blocks were chosen from the pathology archive of Imam Reza hospital collected during the last 10 years. Ki67 antigen immunohistochemical procedures, along with mitotic count and necrosis were performed by a collaborator pathologist. The collected data were analyzed by SPSS software and P-value less than 0.05 was considered a statistically significant level. Results: The mean incidence of Ki67 antigen in the neuroendocrine tumors of the lung was 57.7± 6.5 and the lowest and highest incidence was 1% and 90%, respectively. In addition, the relationship between Ki67 antigen incidence and mitotic count and necrosis were significant while no significant relationship was observed between Ki67 antigen incidence and tumor size in typical carcinoid tumors. Conclusions: Overall, the Ki67 antigen is regarded as a useful and essential tool for grading neuroendocrine lung tumors. [ABSTRACT FROM AUTHOR]

Introduction: Kidney transplantation has considerably increased the survival and life quality of patients with end-stage renal disease. Objectives: The current study was designed to investigate the circulating level of dephosphorylateduncarboxylated matrix gamma carboxyglutamate protein (dp-ucMGP) as a marker of vitamin K status and vascular calcification in kidney transplant recipients as well as its association with the allograft function. Patients and Methods: In this cross-sectional study, 90 eligible kidney transplant recipients were evaluated in the post-transplant phase (about 6-12 months after kidney transplantation). The serum levels of dp-ucMGP, urea, creatinine and other biochemical indices were determined. Results: The mean serum level of dp-ucMGP was 3.78±3.79 µg/L. Most of the participants (80%) had a normal range of serum dp-ucMGP (<4 µg/L). However, 10% had high serum dp-ucMGP (>12 µg/L). Serum dp-ucMGP did not have any statistical significant association with serum urea, creatinine and kidney function (P > 0.05). Conclusion: Further epidemiologic studies are needed to assess the time trends of dp-ucMGP after renal transplant and its relation to kidney function, since high serum level of dp-ucMGP may make kidney transplant recipients prone to various cardiovascular disease (CVD) and transplant rejection. [ABSTRACT FROM AUTHOR]

Background: Diabetes is the fifth leading cause of death in the world. Hence, we investigated the factors affecting disease control among diabetic patients referred to Imam Reza Hospital (central hospital in the Northwest of Iran). Materials and Methods: One hundred and eight diabetic patients were evaluated. Patient's main medications including insulin, metformin, glibenclamide, and glytazon were registered and the levels of fasting blood sugar (FBS), glucose 2 h postprandial (pp), and hemoglobin A1c (HbA1c) were measured. All risk factors were evaluated by using a questionnaire completed by the patients. Results: The average of HbA1c, FBS, and glucose 2 h pp was 7.33%, 159 mg/dl, and 233.03 mg/dl, respectively. In patients whose disease was controlled, the family history of the disease, the type of medication, and the visits to family physician had a significant association with disease control. The average mean of HbA1c among patients with controlled and uncontrolled disease was 5.93% and 8.63 % respectively. Conclusion: Less stress, education, and weekly exercise had an essential role in controlling the disease in diabetic patients from the Northwest of Iran and noncompliance with the prescribed diet by the physician and lack of timely medicine intake were the main reasons for uncontrolled disease. [ABSTRACT FROM AUTHOR]