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After adjustment for age, sex, BMI, and energy intake, we found a positive significant relationship between the first pattern and eGFR (P = 0.031). A positive significant association between adherence to the traditional dietary pattern and urine creatinine was also observed (P = 0.035). In addition, in logistic regression model and after control for covariates, a positive association was observed between adherence to traditional dietary pattern with odds of eGFR less then 60 ml/min/1.73 m2 (P = 0.043) and urinary albumin-to-creatinine ratio ≥ 30 mg/g (P = 0.038). Conclusion It is concluded that higher adherence to the healthy dietary pattern may improve renal function while Iranian traditional pattern was associated with significantly increased odds of incident CKD and albuminuria. Copyright © 2020 Journal of Research in Medical Sciences.Background Cardiac rehabilitation exerts anti-inflammatory effect on several cardiovascular diseases; however, these effects were not described for Chagas cardiomyopathy, which is associated with pro-inflammatory imbalance. Materials and Methods Ten patients with severe Chagas cardiomyopathy performed 8 months of exercise training in a cardiac rehabilitation program. Interleukin-1 beta (IL-1β), IL-8, IL-10, interferon gamma (IF-γ), tumor necrosis factor alpha (TNF-α), and monocyte chemoattractant protein-1 (MCP-1) serum levels were measured using enzyme-linked immunosorbent assay at baseline, 4, and 8 months. The influence of exercise on cytokine levels was evaluated using the one-way analysis of variance for repeated measurements, with Bonferroni posttest for multiple comparisons. Results Levels of pro-inflammatory (TNF-α, IL-1β, IL-8, IF-γ, and (MCP-1) and anti-inflammatory (IL-10) cytokines did not vary significantly during the observation period. Conclusion Exercise may benefit patients with severe Chagas cardiomyopathy by curbing the production of pro-inflammatory cytokines in this disease characterized by a continuous state of inflammation. Copyright © 2020 Journal of Research in Medical Sciences.Primary aldosteronism is one of the most common causes of secondary hypertension. This condition is characterized by autonomous hypersecretion of aldosterone which produces sodium retention and potassium excretion, resulting in high blood pressure and potential hypokalemia. Transient postoperative hyporeninemic hypoaldosteronism with an increased risk of hyperkalemia may occur in some patients. We report the case of a 63-year-old patient with persistent hypokalemia, periodic paralysis, and refractory hypertension who was diagnosed with primary hyperaldosteronism due to elevated aldosterone, undetectable plasmatic renin concentration, and the presence of a left adrenal mass. One month after the surgery, the patient was admitted with signs of severe hyperkalemia (8 mmol/L) and worsened renal function, thus requiring hemodialysis. Fluid resuscitation, loop diuretic, and sodium bicarbonate treatment decreased his potassium. Zona glomerulosa insufficiency was confirmed by hormonal tests which exposed low aldosterone-renin axis. The fludrocortisone treatment was initiated and maintained, with consequent potassium and creatinine stabilization. Old age, long duration of hypertension, impaired renal function, severe hypokalemia before surgery, and large size of the aldosterone-producing adenoma are important risk factors for serious potassium imbalance after removal of the adenoma. We have to consider monitoring the patients after surgery for primary hyperaldosteronism in order to prevent severe hyperkalemia; therefore, postoperative immediate follow-up (arterial pressure, potassium, and renal function) is mandatory. Copyright © 2020 Journal of Research in Medical Sciences.Background Percutaneous dilatational tracheostomy (PDT) is the most commonly used minimally invasive procedure in patients with prolonged mechanical ventilation. However, during the procedure withdrawal, the endotracheal tube (ET) may cause substantial gas leak and sometimes the airway could be lost, and the patient exposed to severe hypoxemia. In order to prevent hypoxemia during ET withdrawal and needle stuck in ET during PDT and also for performing the procedure more safe and easy. Material and Methods In this study, we introduce a new instrument "downpipe endotracheal tube" that has been registered as a patent and examined it in eight patients to confirm practical advantage of this tube. Results These patients were five female and three male, with a mean weight of 71.7 kg and the mean age of 65.12 years. The cause of tracheostomy was difficult weaning from mechanical ventilation. Conclusion The procedure was safe in all cases. see more We did not find any complications during the procedure. Copyright © 2020 Journal of Research in Medical Sciences.Background Conventional hepatitis B virus vaccination fails to achieve efficient protection in about 5%-10% of the world population. Different factors influence the immunogenicity of hepatitis B vaccine. This study aimed to evaluate these factors in health-care workers. Materials and Methods This was a descriptive study which was implemented among 140 of medical and dental staff working as health-care workers who were low responder after vaccination entered the study. Results Age (>40 years), weight (body mass index >25), immunodeficiency diseases, (primary immune deficiency and immunosuppressant drugs), diabetes mellitus, and smoking were the important factors. Conclusion In the high-risk group of hepatitis B disease, the risk factors of immunogenicity must be evaluated at vaccination and check titers of antibody after vaccination. Copyright © 2020 Journal of Research in Medical Sciences.Background Primary tumor resection (PTR) in metastatic colorectal cancer (mCRC) has not been suggested by guidelines, since new systemic chemotherapy options have improved overall survival. However, the effect of PTR is still controversial in mCRC. In this study, we aimed to evaluate the effect of PTR on survival in unresectable mCRC. Materials and Methods Two hundred and fifty-two patients with unresectable mCRC were screened retrospectively between January 2007 and December 2017 and a total of 147 patients who met inclusion criteria were included. The patients with emergency or elective PTR and the patients without surgery were compared for baseline features and overall survival. Results The median follow-up time was 15.6 months (range; 1.2-78.9) in whole patients. There were 91 patients in nonsurgical (NS) group and 56 patients in PTR group. The median overall survival was significantly longer in PTR group compared NS group (21.8 vs. 17.0 months, P = 0.01), but it was not associated to better overall survival in multivariate Cox analysis (hazard ratio 0.
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