• Title/Summary/Keyword: positive CI

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Prevalence of methicillin-resistant Staphylococcus aureus in Iranian children: a systematic review and meta-analysis

  • Sarrafzadeh, Farhad;Sohrevardi, Seyed Mojtaba;Abousaidi, Hamid;Mirzaei, Hossein
    • Clinical and Experimental Pediatrics
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    • 제64권8호
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    • pp.415-421
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    • 2021
  • Background: Antibiotic resistance is associated with longer hospitalizations, higher treatment costs, and increased morbidity and mortality rates. Purpose: This study aimed to determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in Iranian children. Methods: International databases, including Web of Science, PubMed, Embase, and Scopus, and Iranian databases, including Scientific Information Database (www.sid.ir), Magiran, and Iranian Database for Medical Literature (idml.research.ac.ir), were systematically searched for articles published between January 2000 and August 2019. Sources of heterogeneity were determined using subgroup analysis and meta-regression. Results: Overall, 343 studies were identified; of them, 20 were included in the meta-analysis to estimate the pooled prevalence. The pooled prevalence of MRSA was 42% (95% confidence interval [CI], 29-55) among culture-positive cases of S. aureus, 51% (95% CI, 39-62) in hospitalized children, and 14% (95% CI, 0.05-27) in healthy children. Conclusion: The overall pooled prevalence of MRSA in children was 42%. Appropriate infection control measures and effective antibiotic therapy are needed.

Regular Physical Exercise and Falling in Middle-Aged and Elderly Population: Results from Korean Longitudinal Study of Ageing

  • Jeong, Sueon;Lee, Hyeon Ji;Kim, Jae-Hyun
    • 보건행정학회지
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    • 제32권1호
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    • pp.21-28
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    • 2022
  • Background: To investigate the association between regular physical exercise and falling experience for 2 years and fear of falling (FOF) in Korean middle-aged and elderly population. Methods: Data from the Korean Longitudinal Study on Aging was used and 3,871 participants who exercised regularly were included at 2006 and follow-up until 2018. An analysis was performed to investigate the association between exercise (exercise time per week and duration) and falls (experience over past 2 years and FOF) using the generalized estimating equation model. Results: Compared to those who exercised more than 5 hours a week (reference group), those who exercised less than 3 hours were more likely to experience falls and FOF (odds ratio [OR], 1.334; 95% confidence interval [CI], 1.059-1.682; OR, 1.218; 95% CI, 1.119-1.326, respectively). Compared to the group who exercised for more than 5 years, those who exercised for less than 1 year were more likely to experience FOF (OR, 1.310; 95% CI, 1.162-1.478). Conclusion: This study showed that there was a negative relationship between physical exercise time and falling experience and FOF in Korean 45 years or more community-dwelling adults. Based on these results, physical activity can be expected to have a positive effect on fall prevention, which implies the need for policy and research on long-term physical activity programs.

Comparison of Extracorporeal Shock Wave Therapy Versus Injection Therapy for Shoulder Disorders: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

  • Dajeong Kim;Hyunjoong Kim
    • Physical Therapy Rehabilitation Science
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    • 제12권1호
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    • pp.48-55
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    • 2023
  • Objective: The purpose of this study is to compare the effects of extracorporeal shock wave therapy (ESWT) and injection therapy through qualitative and quantitative analysis by synthesizing randomized controlled trials (RCTs) conducted on patients with various shoulder diseases. Design: A systematic review and meta-analysis of randomized controlled trials Methods: This review conducted a literature search through international electronic databases in January 2023 to compare the effects of ESWT and injection therapy. Qualitative analysis was performed as a risk of bias tool, and quantitative analysis was synthesized with a random effect model to show the effect size as a standardized mean difference (SMD). Results: Five RCTs involving 298 individuals with shoulder disorders were included in this systematic review and meta-analysis. ESWT showed a moderate effect on pain (SMD=-0.44; 95% CI, -0.95 to 0.06) and a large effect on shoulder function (SMD =-0.81; 95% CI, -1.70 to 0.07) than injection therapy. A significant difference was found in the shoulder range of motion, showing a large effect size (SMD=1.50; 95% CI, 0.58 to 2.43). Conclusions: When considering treatment options for the management of patients complaining of shoulder disorders, it is appropriate to recommend ESWT first rather than injection therapy to increase the range of motion of the joint. In addition, ESWT is safe for pain control and shoulder function improvement, and a positive prognosis could be expected.

Cisplatin Plus Gemcitabine for Treatment of Breast Cancer Patients with Brain Metastases: a Preferential Option for Triple Negative Patients?

  • Erten, Cigdem;Demir, Lutfiye;Somali, Isil;Alacacioglu, Ahmet;Kucukzeybek, Yuksel;Akyol, Murat;Can, Alper;Dirican, Ahmet;Bayoglu, Vedat;Tarhan, Mustafa Oktay
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권6호
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    • pp.3711-3717
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    • 2013
  • Background: To assess the efficacy and tolerability of Cisplatin plus Gemcitabine combination in patients with brain metastases (BM) from breast cancer (BC). Materials and Methods: Eighteen BC patients with BM who were treated with Cisplatin plus Gemcitabine regimen between 2003-2011 were evaluated. Results: A median of 6 cycles of this regimen were received, in fifteen patients (83.3%) as first-line chemotherapy, in 2 as second-line and in 1 as third-line after diagnosis of BM. Dose reduction was performed in 11 (61.1%) patients; major reasons were neutropenia and leukopenia. Grade III neutropenia and Grade II trombocytopenia rates were 33.3% and 16.7% respectively. Overall response rate (ORR; complete+partial response rate) was 33.4% (n=6) for the entire study population; triple negative patients achieved an 66.6% ORR while hormone receptor (HR) positive patients had 25% and HER2 positive patients 12.5%. Median progression-free survival was 5.6 months (2.4-8.8 months, 95%CI) and longer in patients with triple negative breast cancer (TNBC) (median 7.4 months, 95%CI, 2.4-12.3 months) than the patients with other subtypes (median 5 months for HER2 positive and 3.6 months for HR positive patients). Median PFS of the patients with TNBC who received this regimen as first-line was 9.2 months (5.2-13.2 months, 95%CI). Conclusions: Cisplatin plus Gemcitabine may be a treatment option for patients with BM from breast cancer. Longer PFS and higher response rates are results that support the usage of this regimen especially for the triple negative subtype. However, further prospective and randomized trials are clearly required to provide more exact information.

P53 and MDM2 Over-expression and Five-year Survival of Kidney Cancer Patients Undergoing Radical Nephrectomy - Iranian Experience

  • Abolhasani, Maryam;Salarinejad, Sareh;Asgari, Mojgan
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권12호
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    • pp.5043-5047
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    • 2015
  • Background: Relatively little is known with certainty about the status and role of p53 or MDM2 in predicting prognosis and survival of renal cell carcinoma. The present study aimed to determine the value of P53 and MDM2 over-expression, alone and simultaneously, to predict five-year survival of patients with kidney cancer in Iran. Materials and Methods: Patients with kidney cancer referred to Hasheminejad Kidney Center between 2007 and 2009, underwent radical nephrectomy and had pathology reports of clear cell, papillary or chromophobe renal cell carcinoma were included in our cohort study. Other histological types of renal cell carcinoma were not included. The patients with missed, incomplete or poor quality paraffin blocks were also excluded. Overall ninety one patients met the inclusion and exclusion criteria. To assess the histopathological features of the tumor, immunohistochemical (IHC) staining of formalin fixed, paraffin-embedded tumor samples were performed. The five-year survival was determined by the patients' medical files and telephone following-up. Results: In total, 1.1% of all samples were revealed to be positive for P53. Also, 20.8% of all samples were revealed to be positive for MDM2.The patients were all followed for 5 years. In this regard, 5-year mortality was 30.5% and thus 5-year survival was 85.3%. According to the Cox proportional hazard analysis, positive P53 marker was only predictor for patients' 5-year survival that the presence of positive p53 increased the risk for long-term mortality up to 2.8 times (HR=2.798, 95%CI: 1.176-6.660, P=0.020). However, the presence of MDM2 could not predict long-term mortality. In this regard, analysis by the ROC curve showed a limited role for predicting long-term survival by confirming P53 positivity (AUC=0.610, 95%CI: 0.471-.750, P=0.106). The best cutoff point for P53 to predict mortality was 0.5 yielding a low sensitivity (32.0%) but a high specificity (97.9%). In similar analysis, measurement of MDM2 positivity could not predict mortality (AUC=0.449, 95%CI: 0.316-.583, P=0.455). Conclusions: The simultaneous presence of both P53 and MDM2 markers in our population is a rare phenomenon and the presence of these markers may not predict long-term survival in patients who undergoing radical nephrectomy.

A Renal Size Discrepancy among the Findings of Renal Sonogram in Children with Their First Episode of Pyelonephritis is One of the Useful Parameters to Predict the Presence of Cortical Defects on the Acute DMSA Renal Scan

  • Kwon, Yoowon;Jin, Bo kyeong;Rhie, Seonkyeong;Lee, Jun Ho
    • Childhood Kidney Diseases
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    • 제23권1호
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    • pp.36-42
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    • 2019
  • Purpose: We investigated whether a renal size discrepancy on a renal sonogram (US) in children with febrile urinary tract infection (UTI) was correlated with the presence of cortical defects on their dimercaptosuccinic acid (DMSA) renal scan. Methods: We examined 911 children who were admitted consecutively to our hospital with their first episode of febrile UTI from March 2001 to September 2014. All enrolled children underwent a US and DMSA scan during admission. According to the US findings, including the renal size discrepancy, data were compared between children with positive and negative DMSA scan results. A positive DMSA scan result was defined as reduced or absent tracer localization and indistinct margins that did not deform the renal contour. Results: Mean renal lengths of the right and left kidneys were larger in children with positive DMSA scan results than in children with negative DMSA scan results ($63.2{\pm}11.3mm$ vs. $58.4{\pm}7.8mm$, P<0.001; $64.9{\pm}11.2mm$ vs. $59.9{\pm}7.9mm$, P<0.001; respectively). A significant difference was observed in both renal lengths between children with positive and negative DMSA scan results ($4.6{\pm}3.8mm$ vs. $3.3{\pm}2.6mm$, P<0.001). A multiple logistic regression analysis, revealed that a small kidney, cortical thinning, and a renal length discrepancy on US findings were significant factors for predicting the presence of cortical defects on an acute DMSA scan [P=0.028, 95% confidence interval (CI) 1.054-2.547; P= 0.004, 95% CI 1.354- 4.810; P<0.001, 95% CI 1.077-1.190, respectively]. Conclusion: In conclusion, a renal size discrepancy on US findings in children with their first episode of febrile UTI was a helpful tool for predicting the presence of cortical defects on an acute DMSA scan.

Association of Cytotoxic T-lymphocyte Antigen-4 Polymorphisms with Malignant Bone Tumors Risk: A Meta-analysis

  • Zhang, Chao;Hou, Wei-Hua;Ding, Xuan-Xi;Wang, Xiong;Zhao, Hui;Han, Xing-Wen;Wang, Wen-Ji
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권8호
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    • pp.3785-3791
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    • 2016
  • Background: Previous studies have assessed the association between the Cytotoxic T-lymphocyte Antigen-4(CTLA-4) polymorphism with the risk of malignant bone tumor, but the conclusions were inconsistent. We aimed to clarify association of cytotoxic T-lymphocyte antigen-4 polymorphisms with malignant bone tumors risk by performing a meta-analysis. Materials and Methods: The databases including PubMed, EMBase databases and the Cochrane Library were searched to identify the eligible studies prior to January 30 2016. Odds ratio (OR) with 95% confidence interval (95%CI) were used to estimate the strengths of the association between the CTLA-4 polymorphism and the malignant bone tumor risks. The meta-analysis was performed by STATA 12.0. Results: Four individual studies with a total of 1003 cases with malignant bone tumor and 1162 controls were included in our meta-analysis. The results of meta-analysis on those data demonstrated that CTLA-4 +49G>A polymorphism was associated with the risk of Ewing's sarcoma and osteosarcoma strongly (A vs. G: OR=1.36, 95%CI:1.20-1.54, p=0.000; AA+AG vs. GG: OR=1.35, 95%CI:1.14-1.61, p=0.001; AA vs. GG: OR=2.24, 95%CI:1.67-2.99, p=0.000; AA vs. AG+GG: OR=2.00, 95%CI:1.53-2.62, p=0.000), but CTLA-4 -318C/T polymorphism was not associated with the risk of malignant bone tumor (C vs. T: OR=0.76, 95%CI:0.76-1.08, p= 0.262; CC+CT vs. TT: OR=0.70, 95%CI:0.41-1.20, p= 0.198; CC vs. TT: OR=0.69, 95%CI:0.40-1.19, p= 0.183; CC vs. CT+TT: OR=0.92, 95%CI:0.75-1.13, p= 0.419). Subgroup analysis showed that there are significantly positive correlations between CTLA-4 +49G>A polymorphism and increased risks of malignant bone tumors in large size of sample (A vs. G: OR=1.347, 95%CI: 1.172,1.548, p=0.000; AA vs. GG: OR=2.228, 95%CI: 1.608,3.085, p=0.000), Ewing's Sarcoma or Osteosarcoma (A vs. G: OR=1.361, 95%CI: 1.201,1.540, p=0.000; AA vs. GG: OR=2.236, 95%CI: 1.674,2.986, p=0.000), and PCR-RFLP or Sequencing(A vs. G: OR=1.361, 95%CI: 1.201,1.540, p=0.000; AA vs. GG: OR=2.236, 95%CI: 1.674,2.986, p=0.000), but CTLA-4 -318C/T polymorphism was not associated with the risk of malignant bone tumors in diagnosis, genotype method, and sample size (all p>0.05). Conclusions: CTLA-4 +49A/G variant was associated with an increased risk of developing the malignant bone tumors, such as Ewing's sarcoma and osteosarcoma. However, it failed to show the association between CTLA-4 -318C/T polymorphism and the risk of malignant bone tumors. Future large-scale studies remain to be done to confirm our conclusions.

Positive Association Between miR-499A>G and Hepatocellular Carcinoma Risk in a Chinese Population

  • Zou, Hong-Zhi;Zhao, Yan-Qiu
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권3호
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    • pp.1769-1772
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    • 2013
  • A case-control study of the association of miR-499A>G rs3746444 with risk of hepatocellular carcinoma (HCC)was conducted. Patients with HCC and healthy control subjects were recruited for genotyping of miR-499A>G using duplex polymerase-chain-reaction with confronting-two-pair primer(PCR-RFLP) analysis. The MiR-499 GG genotype was associated with a decreased risk of HCC as compared with the miR-499 AA genotype (adjusted OR=0.74, 95%CI=0.24-0.96). Similarly, the GG genotype showed a 0.45-fold decreased HCC risk in a recessive model. The MiR-499 G allele was significantly associated with decreased risk of HCC among patients infected with HBV in a dominant model (OR=0.09, 95%CI= 0.02-0.29). In conclusion, the MiR-499A>G rs3746444 polymorphism is associated with HCC risk in the Chinese population, and may be useful predictive marker for CAD susceptibility.

An Association between Liver Markers and Physiological Variables: Comparison between Normal and Fatty Liver Subjects

  • Hyun, Kyung-Yae
    • 대한의생명과학회지
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    • 제17권2호
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    • pp.105-112
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    • 2011
  • We evaluated whether liver markers such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyltranspeptidase (GGT), and bilirubin have a relationship with other physiological factors in the normal (n=115) and fatty liver subjects (n=122) and there are differences between the two populations. Body indices were higher in the fatty liver group than in the normal group. Liver markers and blood pressure (BP) were greater in the fatty liver group than in the normal group. AST and ALT levels were positively correlated with body indices in the fatty liver group, but not in the normal group. AST, ALT and GGT levels in the fatty liver group had positive relationship with cardiovascular indices (CI). ALP and bilirubin levels were negatively associated with some of CI. Liver markers were negatively or positively correlated with inflammatory markers, thyroid hormones, or several biochemical markers levels. These findings suggest that abnormal changes in liver markers may be useful tool for diagnosis or prognosis of development of cardiovascular and/or inflammatory diseases as well as metabolic syndrome.

Antitumor Effect Of Bismuth-conjugated Anti-IL-2R Monoclonal Antibody(2E4) on a IL-2 Receptor Positive Tumor EL4J3.4

  • Kim, Sung-Hoon;Robert-W. Kozak;Chung, Kyeong-Soo;Ahn, Byung-Zun
    • Archives of Pharmacal Research
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    • 제17권3호
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    • pp.194-198
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    • 1994
  • The antitumor effects of the 2E4 and anti--Tac, monoclonal antibodies directed to Il-2 receptor (IL-2R) conjugated with .alpha.-particle emitting radionuclide bismuth-212., were compared. The $^{212}Bi-2E4$ demonstratedspecific cytotocicity to EL4J3, 4, a I$L-2R^+$ cell line, than to EL4J, a $IL-2R^-$ cell line in thymidine incorporation assy. TEX>$^{212}Bi-2E4$ exerted the maximal antitumor effect in that % T/C in C57BL/6 mice implanted with EL4J3.4 ascitic tumor was 331% at the concentration of $50{\;}{\mu}Ci$, while that of $^{212}Bi-anti-Tac$ was 258% at $100{\;}{\mu}Ci$.

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