The purpose of this investigation was to assess the correlation of two biomarkers with the occurrence of renal flares in systemic lupus erythematosus (SLE). Urine levels of monocyte chemotactic protein-1 (MCP-1) and transforming growth factor beta (TGF-β) were measured at baseline, and at two and four months in five groups of patients: 25 lupus nephritis patients with active disease (active LN), 10 lupus nephritis patients with SLE in remission (remission LN), 25 patients with clinical active SLE and without nephritis (active NLN), 10 patients without nephritis with SLE in remission (remission NLN) and 10 healthy controls. We used repeated measurement and ANOVA with Duncan's post hoc to analyze the data; the urine level of the two proteins could distinguish the groups based on the existence of lupus nephritis and/or activity of SLE disease. Furthermore we performed receiver operating curve analysis to identify a cutoff point with a good sensitivity and specificity to diagnose lupus nephritis with either one of the urine proteins. Finally the samples from active LN were grouped according to whether they were Class IV or other classes. Baseline urinary MCP-1, but not TGF-β, was significantly different between the classes. Further investigation into the use of these cytokines in a prospective study is needed to determine their capacity as diagnostic tools for renal flares.

Background: Complex decongestive therapy (CDT) is one of the most common treatments used in lymphedema. Effects of lymphedema treatment and its predictive factors were studied previously but its impact on quality of life (HRQOL) is still unknown. Objectives: This study, in addition to investigating CDT effects on HRQOL, examined factors that can influence it, to estimate the effect of treatment according to patient's condition in our setting. Patients and Methods:The present study was a quasi-experimental study on health-related HRQOL. A general data gathering form was used in 120 patients who developed lymphedema following breast cancer surgery and referred for treatment to Shiraz Motahari clinic in 2014. All patients' arm size was measured by "direct voltmeter" before the intervention to determine the grade of lymphedema. SF-36 questionnaire was used pre-and one month post-intervention to collect HRQOL data. Complete decongestive therapy (CDT) with or without Pump was used as the intervention. Results: Patients had higher scores after treatment in all subscales of quality of life (except for "role limitation due to physical problems"), but a statistically significant difference (P = 0.023) was observed only in the "mental health" subscale. The results showed significant changes in bodily pain after the intervention in patients less than 40 years old (P = 0.03), "general health" and "vitality" in single patients (P values equal to 0.013 and 0.02, respectively) and "mental health" in those with education "less than high school" (P = 0.018). In the case of household patients, only PF changed significantly after treatment (P = 0.027). Moreover, "role limitation due to physical problems" and "mental health" subscales changed significantly after treatment with CDT + Pump (P values equal to 0.004 and 0.003). Other groups represented no significant changes in other subscales. Besides, duration of lymph edema had no effect on improvement of HRQOL after treatment. Conclusions: Although this study showed that some factors can improve patients' feeling and HRQOL after treatment in our population, in many aspects no changes were observed. It is recommended to improve patients' HRQOL through more social and physiological support in our setting. Also, more follow-up duration after the intervention is recommended in future studies.

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Background:Most medical errors are preventable. The aim of this study was to compare the current execution of the 3 patient safety solutions with WHO suggested actions and standards.Methods:Data collection forms and direct observation were used to determine the status of implementation of existing protocols, resources, and tools.Results:In the field of patient hand-over, there was no standardized approach. In the field of the performance of correct procedure at the correct body site, there were no safety checklists, guideline, and educational content for informing the patients and their families about the procedure. In the field of hand hygiene (HH), although availability of necessary resources was acceptable, availability of promotional HH posters and reminders was substandard.Conclusions:There are some limitations of resources, protocols, and standard checklists in all three areas. We designed some tools that will help both wards to improve patient safety by the implementation of adapted WHO suggested actions.