The results show that these three urine-based microRNAs might be a good choice to implement a specific and non-invasive diagnostic tool for bladder and prostate cancer. The expression pattern of all three microRNAs was particularly useful to distinguish benign and invasive tumors in prostate cases. From the patients' perspective the improvement of the diagnostic situation is awaited eagerly.
Context:Restless legs syndrome (RLS) is an irresistible urge to move legs that usually occur during inactivity and at night. This neurologic condition is associated with increased risk of nocturnal hypertension as well as cardiovascular events and affects patient’s sleep, which leads to anxiety, depression, and decreases quality of life. Presence of RLS in patients on hemodialysis is associated with higher mortality rate. Most of the times, patients have indescribable symptoms. The aim of this review was to provide physicians with information to be aware and turn their attention to the patient’s symptoms, which are the most important clue to diagnosis of RLS.Evidence Acquisition:For data extraction, we reviewed PubMed, Scopus, Google scholar, the Cochrane collaboration, and Up to Date databases with the keywords of restless legs syndrome, sleep disorders, and end-stage renal disease (ESRD). The most recent review articles, clinical trials, and cross-sectional studies with large sample sizes that had used International RLS Study Group criteria (IRLSSG) and had focused on demographic characteristics and renal function were included. This situation has described in primary and secondary forms. The former usually occurs in younger patients and seems to have genetic tendencies and the latter is due to the iron deficiency state, pregnancy, and ESRD.Results:Two major theories are developed regarding the pathophysiology of RLS. The first one concerns central nervous system dopamine imbalance and the second one concerns intracellular iron dysregulation. The most common used pharmacologic agents in treatment of RLS are dopamine agonists. Other used therapeutic agents include levodopa, Alpha-2-delta calcium channel ligands, opioids, anticonvulsants, benzodiazepines, clonidine, iron therapy in low levels of serum ferritin, and nonpharmacologic therapies.Conclusions:The most important factor in diagnosis is physician’s attention and clinical experience with this condition and using IRLSSG.
BackgroundAutosomal dominant polycystic kidney disease (ADPKD) is a genetic ciliopathy disease characterized by progressive formation and enlargement of cysts in multiple organs. The kidneys are particularly affected and patients may eventually develop end-stage renal disease (ESRD). We hypothesize that bone marrow mesenchymal stromal cells (BMMSCs) are renotropic and may improve kidney function via anti-apoptotic, anti-fibrotic, and anti-inflammatory effects. In this study, we aim to assess the safety and tolerability of a BMMSC infusion in ADPKD patients.MethodsWe performed a single-arm phase I clinical trial with a 12-month follow-up. This study enrolled six eligible ADPKD patients with an estimated glomerular filtration rate (eGFR) of 25–60 ml/min/1.73 m2. Patients received autologous cultured BMMSCs (2 × 106 cells/kg) through the cubital vein according to our infusion protocol. We investigated safety issues and kidney function during the follow-up visits, and compared the findings to baseline and 1 year prior to the intervention.ResultsThere were no patients lost to follow-up. We observed no cell-related adverse events (AE) and serious adverse events (SAE) after 12 months of follow-up. The mean eGFR value of 33.8 ± 5.3 ml/min/1.73 m2 1 year before cell infusion declined to 26.7 ± 3.1 ml/min/1.73 m2 at baseline (P = 0.03) and 25.8 ± 6.2 ml/min/1.73 m2 at the 12-month follow-up visit (P = 0.62). The mean serum creatinine (SCr) level of 2 ± 0.3 mg/dl 1 year before the infusion increased to 2.5 ± 0.4 mg/dl at baseline (P = 0.04) and 2.5 ± 0.6 mg/dl at the 12-month follow-up (P = 0.96). This indicated significant changes between the differences of these two periods (12 months before infusion to baseline, and 12 months after infusion to baseline) in SCr (P = 0.05), but not eGFR (P = 0.09).ConclusionsThis trial demonstrated the safety and tolerability of an intravenous transplantation of autologous BMMSCs. BMMSC efficacy in ADPKD patients should be investigated in a randomized placebo-controlled trial with a larger population, which we intend to perform.Trial registrationClinicalTrials.gov, NCT02166489. Registered on June 14, 2014.Electronic supplementary materialThe online version of this article (doi:10.1186/s13287-017-0557-7) contains supplementary material, which is available to authorized users.
BackgroundThe effectiveness of health care and health policy developments are often determined by health-related quality of life (HRQOL) assessment.ObjectivesThe objective of this study was to explore the potential corresponding factors and traditional biomarkers of HRQOL in a large number of Iranian hemodialysis patients.Patients and MethodsA total of 6,930 chronic hemodialysis (HD) patients enrolled. KDCS-SF version 1.3 questionnaire was used to assess the health related quality of life (HRQOL). We pooled PCS, MCS and KDCS scores with random effect model from 19 similar studies performed between 1996 and 2010ResultsThe mean age was 54.4 ± 17.1 years. Mean PCS, MCS and KDCS scores obtained for the study cohort were 40.79 ± 20.10, 47.79 ± 18.31 and 57.97 ± 11.70, respectively; the total score of SF-36 plus KDCS was 51.12 ± 13.41 as well. The most common primary known disease was hypertension (31.9%) and the second etiology was diabetes (25.5%). In multilevel logistic regression, Kt/V between 1 and 1.2 and PCS, KDCS more than 50 were considered as a significant reduction in the risk of hospitalization.ConclusionsThis study showed that PCS and MCS score were slightly more than overall results while KDCS was slightly less than overall results. In addition, dialysis adequacy with Kt/V between 1 and 1.2 is associated with lower rate of hospitalization.
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