Global prevalence of urinary tract infection in pregnant mothers: a systematic review and meta-analysis

OBJECTIVE

Urinary tract infection (UTI) is a prevalent infection during pregnancy that can lead to complications for both the mother and the foetus. The objective of this systematic review and meta-analysis is to determine the global prevalence of UTIs (both symptomatic and asymptomatic) during pregnancy, based on previous studies in this area. Furthermore, this study aims to identify any factors that contribute to heterogeneity in the prevalence of UTIs during pregnancy.

STUDY DESIGN

Systematic review and meta-analysis.

METHODS

This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines on August 8, 2022. To conduct the systematic review and meta-analysis, a search was performed using the keywords "urinary tract system", "UTI", "pregnancy", and "gestation" was performed in several databases, including Web of Science (WoS), PubMed, Scopus, ScienceDirect, Embase, and Google Scholar, without a time limit until September 18, 2022. The analysis was performed using a random-effects model, and the heterogeneity of the studies was assessed using the I2 index. The Comprehensive Meta-Analysis software (Version 2) was used for data analysis.

RESULTS

The systematic review and meta-analysis of 27 studies, which included a total of 30,641 pregnant women, showed an overall prevalence of UTI (both symptomatic and asymptomatic) to be 23.9% (95% confidence interval: 16.2-33.8). Meta-regression analysis was conducted to examine the impact of two factors, namely study sample size and study year, on the heterogeneity of the meta-analysis. The results revealed that an increase in sample size, and the study year was associated with a decrease in the prevalence of UTI in pregnant women (P < 0.05).

CONCLUSION

The results of our study indicate a global prevalence of UTI in pregnant women to be 23.9%. Therefore, it is recommended that all pregnant women undergo regular UTI screening tests and receive prompt treatment if diagnosed with UTI. Early detection and treatment of UTI during pregnancy are crucial to prevent complications that may affect the health of both the mother and the foetus.

Pharmacovariome scanning using whole pharmacogene resequencing coupled with deep computational analysis and machine learning for clinical pharmacogenomics

BACKGROUND

This pilot study aims to identify and functionally assess pharmacovariants in whole exome sequencing data. While detection of known variants has benefited from pharmacogenomic-dedicated bioinformatics tools before, in this paper we have tested novel deep computational analysis in addition to artificial intelligence as possible approaches for functional analysis of unknown markers within less studied drug-related genes.

METHODS

Pharmacovariants from 1800 drug-related genes from 100 WES data files underwent (a) deep computational analysis by eight bioinformatic algorithms (overall containing 23 tools) and (b) random forest (RF) classifier as the machine learning (ML) approach separately. ML model efficiency was calculated by internal and external cross-validation during recursive feature elimination. Protein modelling was also performed for predicted highly damaging variants with lower frequencies. Genotype-phenotype correlations were implemented for top selected variants in terms of highest possibility of being damaging.

RESULTS

Five deleterious pharmacovariants in the RYR1, POLG, ANXA11, CCNH, and CDH23 genes identified in step (a) and subsequent analysis displayed high impact on drug-related phenotypes. Also, the utilization of recursive feature elimination achieved a subset of 175 malfunction pharmacovariants in 135 drug-related genes that were used by the RF model with fivefold internal cross-validation, resulting in an area under the curve of 0.9736842 with an average accuracy of 0.9818 (95% CI: 0.89, 0.99) on predicting whether a carrying individuals will develop adverse drug reactions or not. However, the external cross-validation of the same model indicated a possible false positive result when dealing with a low number of observations, as only 60 important variants in 49 genes were displayed, giving an AUC of 0.5384848 with an average accuracy of 0.9512 (95% CI: 0.83, 0.99).

CONCLUSION

While there are some technologies for functionally assess not-interpreted pharmacovariants, there is still an essential need for the development of tools, methods, and algorithms which are able to provide a functional prediction for every single pharmacovariant in both large-scale datasets and small cohorts. Our approaches may bring new insights for choosing the right computational assessment algorithms out of high throughput DNA sequencing data from small cohorts to be used for personalized drug therapy implementation.

The effect of the combined use of complex decongestive therapy with electrotherapy modalities for the treatment of breast cancer-related lymphedema: a randomized clinical trial

Background

We evaluated the effects of combined complex decongestive therapy (CDT) with electrotherapy modalities (ultrasound and faradic currents) in patients with breast cancer-related lymphedema (BCRL), investigating upper extremity circumference, volume, pain, and functional disability.

Methods

Thirty-nine patients with unilateral BCRL were randomly allocated to three groups (n = 13) as the following: The control group received CDT, the ultrasound group received CDT and therapeutic ultrasound, and the faradic group received CDT and faradic current. All the participants underwent treatment for 10 sessions. The outcomes including volume, circumference (measured at five points), pain intensity, and functional disability of the affected upper extremity were evaluated at baseline and after the treatment.

Results

Following the treatment, an improvement was noted in lymphedema volume, pain, and functional disability in all the three groups and there was a significant difference between the groups (P < 0.05). However, changes in limb circumference at the end of the treatment were not significantly different among the three groups in any sites (P > 0.05).

Conclusion

The combination of electrotherapy modalities, faradic current or ultrasound, with CDT can result in a greater reduction in lymphedema volume, pain, and functional disability in patients with BCRL.

Trial registration

IRCT, IRCT201310292391N14, registered 03/01/2016.

Physiological role of adiponectin in different tissues: a review

Adiponectin is the most important adipokine secreted by the adipose tissue. It carries out an important role in setting up the metabolism and improving the function of various organs. Adiponectin in the kidneys prevents degradation of the renal arteries, reduces protein excretion, and improves filtration. This role is accomplished by regulating anabolic pathways and reducing oxidative stress in the renal tissue. This hormone in the liver prevents the accumulation of fat and free radicals that cause damage to liver cells and tissue. This adipokine, by preventing inflammatory processes, oxidative stress, obesity and insulin resistance, improves vascular function and prevents the development of atherosclerosis. It seems that adiponectin can also be a therapeutic target for many metabolic diseases. This study aims to clarify the adipose tissue discharge. Here, the diverse physiological actions of adiponectin were reviewed to provide an overview of its therapeutic potential in different metabolic disorders.

Effectiveness of meglumine antimoniate against L. tropica in a recently emerged focus of cutaneous leishmaniasis in Birjand, eastern Islamic Republic of Iran

With limited options to treat cutaneous leishmaniasis, constant monitoring of the rate of resistance to pentavalent antimony-based drugs is needed. This study identified the infecting Leishmania species and evaluated the results of meglumine antimoniate (Glucantime®) therapy in a new focus of cutaneous leishmaniasis in Birjand, eastern Islamic Republic of Iran. Smears from 150 patients showed that 141 patients were infected by L. tropica and 9 by L. major. In total, 141 patients with L. tropica infection completed Glucantime® treatment and follow-up; 63.8% were treated intralesionally and 36.2% by intramuscular administration. The overall success rate after one course of therapy with Glucantime® was 96.5% (136/141), and all the failures (5/141) occurred with intramuscular injections. Statistical analysis showed a significant difference between the failure rates of intramuscular and intralesional injections. Children < 10 years old had a significantly higher failure rate than adults.

Comparison of serum progesterone in non-viable pregnancy and ectopic pregnancy

Ectopic pregnancy (EP) and miscarriage are important differential diagnosis of first trimester vaginal bleeding. In first trimester, serum progesterone value can be 5-20 ng/ml in EP and miscarriage. Since delay in diagnosis of EP could have high mortality and morbidity, the aim of this study was comparison of serum progesterone value in EP and miscarriage in order to differentiate these conditions. A total of 60 patients (30 EP and 30 miscarriages) with gestational age of 5-7 weeks by LMP were enrolled in this study. The titer of progesterone and βhCG of serum were measured. The mean of progesterone and βhCG titers were compared in two groups by Student's t-test. The mean progesterone titer for all patients was 6.36±5.62 ng/ml, with a minimum value of 0.44 and maximum value of 21.50 ng/ml. Serum progesterone level in 33 patients was lower than 5 ng/ml and in 27 patients was between 5-25 ng/ml. Mean serum progesterone for miscarriage was 6.803±5.72 and for EP was 5.915±5.45 ng/ml. Difference between two values was not significant statistically (P=0.067). Mean βhCG for miscarriage was 1313.04 IU/l and for EP 1805.56 IU/l. Mean patients age were 27.2 totally that for miscarriage was 25.8 and for EP 28.5 years. This study indicated, the mean value of progesterone could not differentiate EP from miscarriage.

The effects of farming system and season on the prevalence of lameness in sheep in northwest Iran

AIMS

To determine the prevalence of lameness in sheep in Urmia, northwest Iran, and compare the effects of production system and season on prevalence.

METHODS

A cross-sectional study, using cluster sampling, was conducted. The selected flocks included 18 with 2,315 sheep from farmed production and 28 with 7,619 sheep from semi-migratory systems, and were visited once in summer (grazing season) and once in winter (housing season). Sheep showing signs of lameness were examined to detect the causes of lameness. Bacteriology and histopathology were also performed if required.

RESULTS

The probability of overall lameness was not affected by farming system (p = 0.40), but in the grazing season was less (OR = 0.62; 95% CI = 0.56-0.69) than in the housing season. Footrot was most the common cause of lameness, occurring in 1,047/1,880 (56%) cases. Among flocks, 40/46 (87%) had ≥ 1 case of footrot. Farming system had no effect on occurrence of footrot (p = 0.85), but the probability of footrot in the grazing season was less (OR = 0.21; 95% CI = 0.18-0.25) than in the housing season. Semi-migratory flocks had less hoof overgrowth (OR = 0.30; 95% CI = 0.16-0.56) than farmed flocks, and the probability of hoof overgrowth in the grazing season was less (OR = 0.19; 95% CI = 0.12-0.29) than in the housing season. The probability of digital abscess was less in semi-migratory flocks (OR = 0.64; 95% CI = 0.46-0.88) than farmed flocks, and in the grazing season was more (OR = 2.14; 95 CI = 1.61-2.85) than in the housing season. The probability of interdigital gland infection was higher (OR = 7.15; 95% CI = 5.36-9.55) in the grazing season than in the housing season. Staphylococcus aureus was isolated from 9/11 (82%) sheep affected with interdigital gland infection.

CONCLUSIONS

Footrot was the main cause of lameness in sheep in both farmed and semi-migratory farming systems in this study, especially in the housing season. In the grazing season, digital abscess and interdigital gland infection should be considered as common causes of sporadic lameness in sheep.

CLINICAL RELEVANCE

In practice, lameness in sheep can be a major concern both in farmed and semi-migratory farming systems, with a high occurrence in the housing season. Footrot was a main cause of lameness in sheep in northwest Iran.

Expression and Purification of Recombinant Mycobacterium Tuberculosis (TB) Antigens, ESAT-6, CFP-10 and ESAT- 6/CFP-10 and Their Diagnosis Potential for Detection of TB Patients

BACKGROUND

One of the most widely used methods to detect tuberculosis (TB) infection is the tuberculin skin test (TST). The completion of Mycobacterium tuberculosis (M. tuberculosis) genome sequence has led to identification of several antigens that can be utilized for accurate diagnosis and control of TB. The aim of this study was to purify the recombinant M. tuberculosis antigens for the evaluation of their potential in TB diagnosis.

METHODS

The recombinant secretory antigens, ESAT-6, CFP-10 and ESAT-6/CFP-10 were produced by PCR and cloning methods. To investigate antigen specific responses of these recombinant antigens in detection of TB, ex vivo enzyme linked immunospot (ELISPOT) test in 30 clinically diagnosed TB patients was evaluated.

RESULTS

The selected M. tuberculosis antigens were cloned, expressed and purified in Escherichia coli (BL21). ELISPOT assay for detection of TB showed the sensitivity of 93, 90 and 100% for recombinant ESAT-6, CFP-10 and ESAT-6/CFP-10 proteins respectively, which is significantly higher than conventional TST.

CONCLUSION

The recombinant antigens of ESAT-6, CFP-10 and ESAT-6/CFP-10 can be used as an accurate means of detecting TB in Iran.

Rat xenograft chondrosarcoma development by human tissue fragment

Chondrosarcoma is one of the most difficult types of cancers to diagnose and treatment. Therefore, the development of a reliable animal model for chondrosarcoma would be a helpful tool to study of the tumor's growth and progression.

AIM

We conducted this study to develop a chondrosarcoma on rat by graft of human chondrosarcoma tumor tissue.

METHODS

Fourteen male Sprague-Dawley rats equally divided in xenograft-implanted and control groups. On the lateral side of the right femur distal 1/3, 5 mm incision was done on the skin after animal anesthesia. Then, was drilled 3 mm on the bone and implanted the xenograft in the bone. Radiography was taken from the operated femur weekly until the fourth week and monthly for 3 months. Four animals of each group were sacrificed after 4 weeks of operation; femur was harvested for histopathological study.

RESULTS

Radiological images showed sclerotic area on the implanted bone after 4 weeks of operation. Sections from tumoral areas reveal cartilage forming hypercellular neoplastic tissue with lobular pattern of growth and foci of adjacent tissue invasion such as bone trabeculas and bone marrow.

CONCLUSION

the present study showed that rat xenograft chondrosarcoma can develop by human chondrosarcoma fresh tissue fragments.

Investigation of fine nanoparticles syngas catalyst (POM) considering their various morphology

Ni/SiO2 fine nanoparticles were prepared by coprecipitation method using various nonionic surfactants as templates with Tylose as a binder dispersant. Scanning Electron Microscope (SEM) and X-ray Diffraction (XRD) have been used to study the templates influence on the morphology of the produced samples. Although the phase structure remained as a tetrahedron amorphous cristobalite-sin-SiO2 (101,100), rhombohedron and cubic NiO, but samples with different morphology (homogeneous nano spherical, nano rose flower and nano cubic shapes) have been achieved. These fine nanoparticles as syngas catalysts in Partial Oxidation of Methane to Hydrogen and Carbon Monoxide (POM) have been studied. Because of high Hydrogen production, it is a candidate to be a green fuel. A fixed-bed reactor at P = 1 atm, T = 800 degrees C, H2/CO = 1.8, GHSV (CH4) = 6000/hr and BET = 25, 63.5 and 87.1 m2/gr have been used as POM catalyst. From other hand these fine compounds could be converted to metallic nanotube (nanofiber) at above 850 degrees C and also bamboo shape tip mode carbon nanotube by thermal chemical vapor deposition at 800 degrees C. Transmission Electron Microscopy confirmed the metallic nanotube or single nano crystal growth. The Raman spectroscopy of all samples has been studied to confirm the different formation of Ni-Si. Choosing different templates for production of these nanoparticles could create width range of medical and industrial applications.

Temporal meningiomas presenting as chronic otitis media

Two cases of temporal bone meningiomas presenting as chronic drainage ears are presented. One case was indicated by computer tomographic scan at the time of initial surgery to be limited to the middle ear, but recurred 9 months later with extensive cerebellopontine angle extension and cranial nerve palsies. The tumor in the second case extended from the middle ear to the cavernous sinus, with extensive intradural involvement. Meningiomas involving the middle ear must be considered to have intracranial extension, and magnetic resonance is the imaging study of choice.

Somatosensory evoked potentials in the evaluation of lumbosacral radiculopathy

We performed lower extremity somatosensory evoked potential (SEP) studies in 59 patients with signs or symptoms suggestive of lumbosacral radiculopathy and compared them with results of myelography with post-myelogram CT (myelogram/CT), MRI, and other electrodiagnostic studies. Of 38 patients with abnormal myelogram/CTs, 32 had abnormal SEPs, while 11 demonstrated EMG abnormalities. All 21 patients with normal myelogram/CTs had normal SEPs. SEP improved electrodiagnostic sensitivity in patients with weakness or reflex changes as well as in those with sensory deficits only. SEP was less sensitive in patients in whom spinal stenosis was the only radiographic finding. MRI generally corresponded well with the results of myelogram/CT and SEP but overestimated the significance of disk bulges in some patients. SEP is useful in the electrodiagnostic evaluation of lumbosacral radiculopathy, particularly when EMG is nondiagnostic.

Synchronous occurrence of parathyroid carcinoma and adenoma in an elderly woman

The simultaneous occurrence of parathyroid carcinoma and other pathologic conditions of the parathyroid on a sporadic basis is extremely rare. Parathyroid exploration in an otherwise healthy 78-year-old woman with no underlying risk factors revealed synchronous right upper parathyroid adenoma and left upper parathyroid carcinoma. The patient's modest hypercalcemia (11.5 to 12.3 mg/dl) was seemingly at variance with remarkable parathormone elevations of 30 to 70 times normal.

Spontaneous dissection of the extracranial vertebral arteries

Though the syndrome of carotid artery dissection is well known, "spontaneous" vertebral artery dissection is rarely recognized. We now report clinical and radiologic findings in five patients with presumed vertebral dissection, one pathologically confirmed. Mean age was 35.2 years (range 27-41). Two were men; three women. None had hypertension, vascular disease, or trauma. Headache and neck or occipital pain was prominent in all, often preceding other symptoms. Four of five patients had unilateral partial alteral medullary syndromes, in one accompanied by medial medullary signs. One patient had a cerebellar infarct. Angiography in four patients showed severe irregular stenosis of the distal extracranial vertebral artery (three bilaterally). A fifth patient with irregular stenosis above the vertebral origin had verified extensive dissection in the resected segment. No patient developed late ischemia. Repeat angiography in three showed healing. We conclude that spontaneous vertebral artery dissection, though rare, has recognizable clinical and radiologic features.

Caudate hemorrhage

We studied 12 patients with intracerebral hemorrhage in the head of the caudate nucleus. These cases accounted for 7% of a consecutive series of intracerebral hemorrhage. The clinical findings differed from more common varieties of supratentorial hemorrhage. All patients had acute onset of vomiting, headache, stiff neck, decreased level of consciousness, and behavioral changes in a pattern that simulated subarachnoid hemorrhage. Seven patients had gaze paresis and hemiparesis, with or without sensory loss. Two of these seven patients had, in addition, elements of Horner's syndrome. The prognosis for recovery was good. No patient had recurrent hemorrhage or persistent hydrocephalus.

Intracerebral hemorrhage secondary to cerebral amyloid angiopathy

Cerebral amyloid angiopathy (CAA) is a cause of intracerebral hemorrhage in a significant proportion of normotensive patients. Two cases of pathologically proved multiple intracerebral hemorrhages due to CAA are reported. These hemorrhages are accurately demonstrated on computed tomography and are typically superficial in location. CAA should be considered as a cause of such hemorrhages in elderly patients who are often normotensive and demented.

Calcified pseudocyst of the pancreas

Pancreatic pseudocysts are encapsulated collections of fluid which may complicate trauma or inflammation of the pancreas. The correct preoperative diagnosis of the pseudocyst can be established easily by the modern techniques of ultrasonography or computed tomography (1-3). However, recognition of the lesion on plain radiographs of the abdomen is rarely possible because the wall and content of pancreatic pseudocysts do not show a visually perceptible difference in density from the adjacent soft tissues (4). This report concerns an exceptional instance whereby a pancreatic pseudocyst was clearly demarcated by virtue of radiographically detectable calcium deposits in its wall.

Giant serpentine intracranial aneurysm

Giant serpentine aneurysms are considered a distinct subgroup of giant aneurysms because of their characteristic angiographic appearance and clinical behavior. A case of this unusual vascular abnormality showing progressive enlargement documented by computed tomography and cerebral angiography is presented, along with a review of the literature. Etiology, pertinent radiological findings, and a probable mechanism of serpentine channel formation are discussed.

Computed tomography in isodense subdural hematoma

Isodense subdural hematomas, particularly bilateral ones, may be difficult to diagnose with CT. Forty-three cases of subdural hematomas were studied by CT, 7 of which were isodense collections. Obliteration or displacement of the cortical sulci in the zone of the extracerebral collection was present in all 7 cases. Infusion scans demonstrated displacement of a cortical vein away from the inner table of the skull in 3 of the 7 cases. This findins is helpful in accurately predicting the size of the extracerebral collection.

Spinal cord compression by vertebral hemangioma

Asymptomatic vertebral hemangiomas occur frequently in adults but the discovery of a similar lesion in the pediatric are group is uncommon. A case which involves all the neural arch components with resultant spinal cord compression is rare and is reported with a review of pertinent literature.