Malignancy is a common complication after renal transplantation. However, limited data are available on post-transplant malignancy in living kidney transplantation. Therefore, we made a plan to evaluate the incidence and types of malignancies, association with the main risk factors and patient survival in a large population of living kidney transplantation. We conducted a large retrospective multicenter study on 12525 renal recipients, accounting for up to 59% of all kidney transplantation in Iran during 22 years follow up period. All information was collected from observation of individual notes or computerized records for transplant patients. Two hundred and sixty-six biopsy-proven malignancies were collected from 16 Transplant Centers in Iran; 26 different type of malignancy categorized in 5 groups were detected. The mean age of patients was 46.2±12.9 years, mean age at tumor diagnosis was 50.8±13.2 years and average time between transplantation and detection of malignancy was 50.0±48.4 months. Overall tumor incidence in recipients was 2%. Kaposis' sarcoma was the most common type of tumor. The overall mean survival time was 117.1 months (95% CI: 104.9-129.3). In multivariate analysis, the only independent risk factor associated with mortality was type of malignancy. This study revealed the lowest malignancy incidence in living unrelated kidney transplantation.
The high incidence of KS in this large population studied, as compared to that reported in other transplant patient groups, suggests that genetic predisposition may play a pathogenetic role.
Objective: Diabetes mellitus is a chronic illness and adherence to medications is vital to manage the illness. The purpose of this study was to examine the prediction of medication adherence based on personality factors in a group of individuals with type 2 diabetes in Yasuj. Materials and Methods: One hundred twenty individuals with type 2 diabetes who visited health centers were selected for this study through convenience sampling. The participants completed the NEO-Five Factor Inventory and Medication Adherence Rating Scale (MARS). The data were analyzed by mean, standard deviation, and multiple regression analysis using SPSS software. Results: The results showed that among the big-five personality factors, only neuroticisms significantly predicted adherence to medications (β= -0.31, P-value< 0.003). Furthermore, the model explained only 19% of the variance in medication adherence (R2= 0.19, P-value< 0.01). Conclusion: This study indicated that a large proportion of patients with type 2 diabetes did not adhere to their medications. This study highlighted that the personality trait of neuroticism was important in predicting medication adherence in patients with type 2 diabetes.
IntroductionAs the first randomized clinical trial, this study evaluated the effect of Famotidine on the improvement of outcomes of hospitalized patients with COVID-19.MethodThis phase III randomized clinical trial was designed with two parallel arms, placebo-controlled, single-blind, and concealed allocation, and recruited 20 patients. Oral Famotidine 160 mg four times a day was given to patients until the discharge day or for a maximum of 14 days. Patients’ temperature, respiration rate, oxygen saturation, lung infiltration, lactate dehydrogenase (LDH) level and complete blood count (CBC) were measured at the baseline (before the intervention) and on day 14 after the intervention or on discharge day. Length of stay in the hospital and length of stay in the ICU were also measured as secondary outcomes of the study.ResultsThe results showed a significant decrease in LDH (P = 0.01), mean WBC (P = 0.04) and length of stay (P = 0.04) of patients with COVID-19 in the group treated with Famotidine compared to the control group. There was also a significant increase in oxygen saturation (P = 0.01) in the group treated with Famotidine compared to the control group. Cough improvement was also higher in the oral Famotidine group compared to the control group (P = 0.02).ConclusionThis was the first clinical trial on the effect of Famotidine on the improvement of hospitalized COVID-19 patients, which indicated that high-dose Famotidine improves patients’ clinical signs and reduces the severity of the disease and duration of hospitalization.
Background: This study aimed to investigate the demographic factors, comorbidities, and laboratory results of diabetic patients with coronavirus disease 2019 (COVID-19) severity. Materials and Methods: This cross-sectional study enrolled 171 diabetic patients with COVID-19 admitted based on chest CT scan findings to the COVID-19 ward of Shahid Mohammadi Hospital in Hormozgan, Iran from 1 March to 1 June, 2020. Reverse-transcriptase polymerase chain reaction (RT-PCR) test was performed, and the patients were divided into three groups (mild, moderate, and severe) based on the severity of disease. Then we investigated the demographic factors, comorbidities, and laboratory results of diabetic patients with severe COVID-19 severity. Results: Regarding comorbidities, there was no significant difference between the three groups. Moreover, there was a significantly lower lymphocyte count in the severe group compared to moderate and mild groups (P = 0.001). We showed the increase in blood urea nitrogen (BUN) and creatinine to be significantly associated with increased disease severity (P = 0.001 and P = 0.009, respectively). We also showed a significant difference in aspartate aminotransferase (AST) levels between different groups of patients (P = 0.002) with a higher level of AST in the severe group (P = 0.020). Lactate dehydrogenase (LDH) and troponin were also significantly associated with an increase in COVID-19 severity in patients with diabetes (P = 0.013 and P = 0.002, respectively). Conclusion: There was a significant association between disease severity and BUN, creatinine, AST, LDH, and troponin levels in diabetic patients with COVID-19. There was no significant association between different groups regarding severity of disease and comorbidities.
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