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Selenium, a trace element present in specific selenoproteins, is essential for thyroid hormone metabolism. Selenium is also an antioxidant with immunosuppressive properties and may help in managing thyroid autoimmune diseases, including Graves’ (GD) hyperthyroidism and Graves’ ophthalmopathy (GO). There were 320 clinical studies related to selenium and thyroid published in English and French between January 1, 2000, and June 1, 2023. Our focus was to identify studies reporting levels of serum selenium in patients with GD and studies that assessed the effect of selenium supplementation on outcomes of GD hyperthyroidism and GO. We also reviewed 20 systematic reviews and meta-analyses of randomized controlled trials that reported selenium levels in GD and the effects of supplementation on GD and GO outcomes. Our review showed that patients with GD had serum selenium levels lower than those of various control patients. In the short-term, a selenium supplement to antithyroid drugs showed benefit for GD hyperthyroidism in most studies, but long-term benefits and positive effects on remission rate were unclear. Some studies did not show benefit. The benefits may depend on baseline selenium deficiency. Two randomized controlled trials showed positive effects of supplementation for mild GO; however, studies about moderate and severe GO are still needed. There is evidence for benefit with short-term selenium supplementation for GD hyperthyroidism, but controlled studies are needed to assess long-term benefits, and benefits in selenium-sufficient areas.

The purpose of this study is to evaluate the clinical and laboratory manifestations of children with mucopolysaccharidosis type 6 before and after enzyme therapy. In this quasi-experimental study, 8 patients with MPS-6 referred to the pediatric endocrinology department of Imam Reza Hospital in Mashhad were followed up for 12 months. The level of urinary glycosaminoglycan was measured to check the response to the treatment. The range of motion of the shoulder and elbow joints was evaluated using a goniometer, and abdominal ultrasound was performed to check the size of the liver and spleen in the midclavicular line. The 6-minute walking test and the 3-minute stair climbing test were performed for the patients at the mentioned times. The height and weight of the patients were also measured, and echocardiography was performed. Then patients underwent weekly enzyme treatment. One of the patients (seventh patient) was excluded from the study. Patients were treated with enzyme from the beginning of the study. The patients were evaluated at 12 months later. Statistical analysis showed that changes in urinary GAG level, height, weight, changes in 6-minute walk and range of motion (extension and flexion) of the shoulder were significant (P<0.05). Changes in liver and spleen size compared to height, climbing stairs, corneal opacity and heart changes after 12 months of enzyme therapy were not significant. It is suggested that even though this method of treatment is not definitive, that can be continued to improve the current condition of the patient.

Chronic kidney disease is a devastating disorder, which complicated the quality of life in affected patients. Determination the epidemiology of end stage renal disease (ESRD) seems necessary to decrease the occurrence of progressive renal damage in at risk patients. This study was performed to investigate the epidemiologic characteristics and treatment modalities of children with ESRD. A cross-sectional study was conducted on 115 children with ESRD admitted during 2020-2022 in a pediatric nephrology center in Southwest of Iran. All children were younger than 18 years and referred for renal replacement therapy (RRT). ESRD was defined as glomerular filtration rate less than 10-15 ml/min/1.73 m² for at least 3 months. Information such as age of ESRD, gender, etiology of ESRD and type of RRT were obtained from their medical records. A total of 115 patients (53% male) were included. Mean age at the time of ESRD was 8.47 years. Males outnumbered females. The most common cause of ESRD was congenital abnormality of kidney & urinary tract (CAKUT) in 36.5% of patients, followed by hereditary disorders. The majority of patients were older than 5 years at the time of ESRD, with a significant correlation to the underlying disorder (P<0.001). Parental consanguinity was detected in 77% of patients, especially in hereditary disorders. RRT was performed in all patients, including hemodialysis in 71.3% and chronic ambulatory peritoneal dialysis in 28.7%, respectively. In conclusion, CAKUT was the most common cause of ESRD in our patient population. was the most common cause of ESRD in our patient population. Prenatal evaluation of all fetuses along with early neonatal screening of susceptible cases is suggested for preventing practice or slowing the progression of chronic kidney disease.

Thyroid function has been shown to be associated with cardiovascular diseases. Moreover, sex can influence on the association between thyroid function and other diseases. We aimed to evaluate the relationship between thyroid hormones and the severity of coronary artery disease (CAD) and outcomes. In a prospective study, patients with chest pain undergoing diagnostic coronary angiography were evaluated. Patients were categorized based on the number of involved coronary arteries. Moreover, the severity of CAD was quantitatively calculated using the Syntax score (SS). All patients were also followed up for 3-month duration. The level of TSH in 150 patients was significantly higher in females than males (3.1 [1.7, 5] versus 1.8 [1, 3.3] mU/L; P=0.002). There was significant correlation between THS and the SS among females (ρ=0.477, P<0.001), but not males. Among both sexes, thyroid hormones were comparable between those with or without events during follow-up. The main predictors of high SS values included age (odds ratio [OR] 1.060, 95% confidence interval [CI] 1.018-1.104; P=0.005) and female (OR 2.941, 95% CI 1.198-7.218). The main predictors of multivessel disease were age (OR 1.077, 95% CI 1.026-1.132), female (OR 5.853, 95% CI 1.880-18.222), thyroxin (OR 0.733, 95% CI 0.547-0.981), and thyrotropin (OR 1.333, 95% CI 1.079-1.647). Thyroid hormones are associated with the presence and the severity of CAD, but it might be sex-related. However, thyroid hormone levels could not predict short-term outcomes of patients.

Respiratory support in infants with respiratory distress syndrome (RDS) plays an important role in the reduction of mortality and complications, but the treatment fails in some infants. This study aimed to identify the predictors of continuous positive airway pressure (CPAP) failure in preterm infants with RDS. This cross-sectional retrospective study was conducted on RDS-diagnosed preterm infants admitted to the neonatal intensive care unit of Fatemieh Hospital (Hamadan city) in 2021-2022. The infants were examined in terms of risk factors for CPAP failure. Data extracted from the medical records were recorded in a checklist and analyzed with SPSS version 21 software at a confidence level of 95%. CPAP failure was recorded in 37.6% of the studied 202 infants. The need for resuscitation at birth, low gestational age, low birth weight, multiple births, low 1-min and 5-min Apgar scores, the need for higher FIO2 and PEEP, acidosis, and the need for surfactant administration were significantly associated with CPAP failure. In logistic regression, low gestational age (OR 1.30, 95% CI: 1.082-1.576) and the need for resuscitation at birth (OR 0.426, 95% CI: 0.202-0.898) were the major predictors of CPAP failure. Lower gestational age and the need for PPV in the delivery room are good predictors of CPAP failure in preterm infants with RDS, who receive nasal CPAP as primary respiratory support.

The birth of premature infants remains a challenge in many societies. This cross-sectional study investigates prenatal care and influential factors in preterm infants hospitalized in the Neonatal Intensive Care Unit (NICU) of Fatemieh Educational-Medical Center in Hamadan, Iran, from March 2018 to March 2019. We examined premature infants with a gestational age of less than 37 weeks who were admitted to the NICU. Data on demographic and maternal characteristics, length of hospital stay, maternal underlying diseases, probable causes of preterm birth, neonatal complications, treatment types, treatment-related complications, resuscitation needs, ventilation, and mortality rates were extracted from patient records. Among 388 preterm infants studied, 204 (52.6%) were female. The mean gestational age was 31.8±2.8 weeks, birth weight was 1647.4±625.6 grams, and average hospital stay was 10.2±9.3 days. The most common maternal underlying disease was pregnancy-induced hypertension or preeclampsia (22.2%), respiratory distress syndrome, jaundice, and low birth weight were the leading reasons for hospitalization (84%). Neonatal outcomes included 92 (23.7%) deaths, 25 (6.4%) intraventricular hemorrhages, 39 (10.1%) patent ductus arteriosus cases, 20 (5.2%) bronchopulmonary dysplasia cases, and 41 (10.6%) retinopathy of prematurity cases. Regression analysis revealed significant predictors of neonatal mortality, including male gender, maternal underlying diseases, need for cardiopulmonary resuscitation, low Apgar score at one-minute, lower birth weight, shorter gestational age, and NICU stay duration. This study underscores the high neonatal mortality rate among preterm infants. Implementing preventive measures, particularly addressing maternal underlying diseases and low birth weight, can significantly reduce neonatal mortality.

Tracheobronchial calcification is a benign radiological finding seen in middle-aged and elderly females, usually of no clinical significance. We report a female with massive tracheobronchial calcification that is found incidentally after cardiac surgery.