The function of every family has a significant impact on the health of its members. Thalassemia is a chronic disease and, as the most common genetic disorder in the world, affects different aspects of life, including emotional well-being. The purpose of this study was to determine the relationship between well-being in children with a Thalassemia major and the function of their families, in Isfahan, Iran, in 2013. This was a cross sectional study and census sampling was used to collect the data. The study sample consisted of 97 children with thalassemia at the age of 10-16 years who referred to the clinic of Imam Reza, Seyed-al-Shohada Hospital in Isfahan. The subjects were evaluated using the Adolescent Psychological Wellbeing Scale and Family Functioning Questionnaire. Data were analyzed using SPSS software. The Pearson correlation coefficient showed that there was a reverse relationship between the overall score of family functioning and illness score of children with thalassemia (r=-0.377, P<0.001). In other words, children with thalassemia who are in families with a higher functionality have a greater sense of well-being. Among the 15 aspects of family functioning, the aspect of expressiveness and Lack of independence had the highest correlation with well-being in children with thalassemia. However, the aspect of locus of control and Disengagement had the lowest correlation with their well-being. The results of this study showed that there is a direct relationship between family functioning and emotional well-being of children with thalassemia major. Therefore, an important task of public health nurses is to improve the function of families in various aspects. The strengthening of family planning and implementation of projects in this regard is also necessary.
Atrial fibrillation seems to be overrepresented among patients with primary aldosteronism. The aim of this study was to determine the usefulness of aldosterone to renin ratio as a screening instrument for primary aldosteronism in an atrial fibrillation population with relatively low cardiovascular risk profile. A total of 149 patients <65 years and with history of AF were screened for primary aldosteronism using aldosterone to renin ratio. Pathologically increased aldosterone to renin ratio (>65 pmol/mIU) was found in 15 participants (10.1%). Further investigation of the positive screened participants and confirmatory saline infusion test resulted in a diagnosis of primary aldosteronism in four individuals out of 149 (2.6%). Three out of the four individuals with primary aldosteronism had previously been diagnosed with hypertension, but only one out of the four had uncontrolled blood pressure, that is, >140/90 mmHg. All participants had normal potassium levels. Individuals with increased aldosterone to renin ratio had significantly higher mean systolic and diastolic blood pressure in comparison to participants with normal aldosterone to renin ratio (136 vs. 126 mmHg, p=0.02 and 84 vs. 78 mmHg, p=0.02). These findings suggest that assessment of aldosterone to renin ratio can be useful for identification of underlying primary aldosteronism in patients with diagnosed atrial fibrillation and hypertension in spite of well controlled blood pressure and normokalemia.
Background: The changes in some epigenetic elements such as microRNAs result in aberrant immune responses leading to production and secretion of nephritogenic autoantibodies as the main fundament of lupus nephritis (LN).Objectives: The present study aimed to assess the miRNA profile of kidney biopsies in patients with LN with the purpose of describing the critical role of these elements in LN creation. Patients and Methods:In this case-control single center study 11 patients who suffered LN (as the case group) and 11 patients with normal kidney function who were candidate for nephrectomy due to cancer or cyst (as the control group) were included. Kidney biopsies were taken from all LN and control subjects. RNA was extracted and converted to cDNA, then the cDNA was evaluated using NANODROP and then intra-renal expression of candidate miRNAs were quantified in the two groups. In the present study, four topranked miRNAs, miR-638, miR-146a, miR-198, and miR-731 were selected for qRT-PCR. Results: Consistent with the microarray data, we found no significant difference in the expression of all miRNAs between LN and control groups. Using REST 2009 software, we did not also reveal any difference in expression of four miRNAs studied between the patients with LN and those without LN in both parametric and nonparametric patterns. Conclusions:The expression of miR-638, miR-146a, miR-198, and miR-731 may not be related to occurrence of LN in Iranian population.
Changes in blood pressure (BP) are now proactively examined throughout the drug development process as an integral aspect of safety monitoring. This is because hypertension is a very strong risk factor for cardiovascular events and drug-induced increases in BP have attracted increased regulatory attention. However, there is currently no guidance from regulatory agencies on the minimum BP data required for submissions, and there are no specific criteria for what constitutes a safety signal for increased BP in non clinical studies. Areas covered: Evaluation of BP increases through the drug discovery and development process. Expert opinion: Research into the effects of drugs should begin before clinical development is initiated and continue throughout the clinical trial program. Non clinical studies should inform a benefit-risk analysis that will aid decision-making of whether to enter the drug into Phase I development. The degree of acceptable risk will vary according to the therapy area, treatment indication and intended population for the new drug, and the approach to BP assessment and risk mitigation should be tailored accordingly. However, BP monitoring should always be included in clinical trials, and data collected from multiple studies, to convincingly prove or refute a suspicion of BP effects.
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