Evaluation of serum cyfra21 in patients with pleural effusion

BACKGROUND

The aim of this study is to determine the level of serum cytokeratin19 fragment (cyfra21-1) in patients with benign or malignant pleural effusion and evaluation the sensitivity and specificity of this tumor marker. METHOD #ENTITYSTARTX00026;

MATERIAL

We prospectively evaluated 98 patients (39 malignant, 54 benign and the results were inconclusive in 5) with pleural effusion. The diagnosis of malignant pleural effusion was defined by cytological or histological results. We used serum cyfra21-1 criteria from literature of Roch company. Level of the marker was determined using electrochemiluminescence.

RESULTS

There was statistically significant difference between mean of serum cyfra21-1 levels of benign (3.9±7.6) and malignant(19.5± 30) pleural effusion (p=0.01). In addition the sensitivity, specificity, positive predictive value and negative predictive value of serum cyfra21-1 at the cut off point of 3.3 ng/ml , was 84% , 61%, 61% and 84 % respectively.

CONCLUSION

Serum cyfra21-1 is useful as a measure in differentiating malignant from benign pleural effusion.

Outcomes of two different polytetrafluoroethylene graft sizes in patients undergoing maintenance hemodialysis

Arteriovenous access creation is mandatory for maintenance hemodialysis. If native fistula placement was not possible or failed, a prosthetic conduit would be the best substitute. The purpose of this prospective study was to compare outcomes of two different sizes of polytetrafluoroethylene (PTFE) grafts, in hemodialysis patients, at the Mustafa Khomeini Hospital in Iran. The study population consisted of 586 end-stage renal disease referrals for vascular access construction (January 2003 to January 2007) of which eventually 102 subjects were candidates for PTFE graft who were followed for one year. Data were collected by a questionnaire and analyzed using the SPSS, life table, Kaplan- Meier and Log-Rank tests. Out of 102 PTFE implantation candidates (mean value of age 51.7 +/- 17.06 yrs), 56% were male and 44% female. PTFE grafts of 8 mm and 6 mm sizes were randomly placed in 57 and 45 subjects, with distribution of 83%, 12% and 5% in arm, forearm and thigh. The most underlying diseases were hypertension and diabetes. There was a significant difference in complication rates between patients with and without underlying diseases [42% vs. 10% (P = 0.03)]. One-year patency rates were 42.2% and 36.5% for 6 mm and 8 mm grafts and 28.2% vs. 52% in patients with and without underlying diseases respectively. Despite more complication frequency in 8 mm grafts, the patency and complication rates of two graft groups did not significantly differ. Hypertension and diabetes could have contributory roles in graft complication rate, which may be preventable. Non-tapered grafts of 6 mm and 8 mm sizes have not significant different outcomes. Further research is recommended with larger sample size and longer duration.

Survey of medical students of Shahed University in Iran about attitude and willingness toward organ transplantation

BACKGROUND

Transplantation is a successful procedure that prolongs the lives of people suffering from debilitating diseases. The purpose of this study was to assess medical students' attitude toward organ donation.

METHODS

The study population consisted of 262 medical students with a mean age of 22.1 +/- 2.5 years who were surveyed using a reliable questionnaire that examined their attitudes and willingness. All data analyses were performed using Chi-square and analysis of variance tests with SPSS.

RESULTS

The medical students had highly positive attitude toward organ donation (mean score 4.34 +/- 0.46) and a great willingness. Participants were more willing to donate their own organs than those of a deceased relative (85% vs 49.2%) to help others more than to develop science (91.2% vs 8.8%). The greatest willingness among students was kidney (84%) donation. There was no correlation between age, gender, education levels, and attitude toward organ donation.

CONCLUSION

These findings necessitate an organized education program of medical students in all aspects of organ and tissue donation.

Case-controlled study of the relationship between delivery method and incidence of post-partum urinary incontinence

The protective role of caesarean section against urinary incontinence was investigated in this descriptive case-controlled study of 125 women with urinary incontinence who had been referred to obstetrics and gynaecology clinics in Tehran, Iran, compared with 125 control women without urinary incontinence. A gynaecologist visited all women to complete a questionnaire and episiotomy scar, stress incontinence, and severity of cystocele and rectocele were also determined. Data were analysed by Student's t-test for quantitative variables, the chi(2)-test for qualitative variables and logistic regression. Increased age and body mass index were found to be significant risk factors of urinary incontinence (bivariate and multivariate analyses). There were also significant relationships between urinary incontinence and gravidity, parity, delivery mode, episiotomy, type of caesarean section (elective or emergency), cystocele, rectocele and chronic constipation (bivariate analysis only). There was no relationship between urinary incontinence and fetal birth weight or maternal employment status. The results suggest that caesarean section can decrease the rate of urinary incontinence.