Search

Energy efficiency of existing buildings is a concept to manage and restrain the growth in energy consumption and one of the crucial issues due to the magnitude of the sector. Educational buildings are in charge of about 15% of the total energy consumption of the non-residential building sector. However, not only operational but also embodied energy of a building should be reduced to get the overall benefits of energy efficiency, where, using energy efficient architectural measures and low emitting materials during every retrofit action can be a logical step. The majority of buildings in Turkey and EU was built earlier than the development of the energy efficiency in the construction sector, hence, without energy retrofit, consume an enormous amount of energy that can be averted significantly by the implementation of some even not advanced retrofit measures. Furthermore, demolishing of a building to construct a new one is not a rational approach concerning cost, time and environmental pollution. The study has been focused on the impact assessment of the various architectural scenarios of energy efficiency upgrading on the Life Cycle Energy Consumption (LCEC) and Life Cycle CO2 (LCCO2) emission. Within the scope of the study, a primary school building is selected to be analysed. Through analysis, the total embodied and operational energy use and CO2 emission regarding the life cycle phase of the building is quantitatively defined and investigated in the framework of life cycle inventory. The paper concentrates on the operation and embodied energy consumption arising from the application of a variety of measures on the building envelope. An educational building with low LCCO2 emissions and LCEC in Turkey is proposed. To exemplify the approach, contributions are applied to a case study in Istanbul as a representative school building. The primary energy consumption of the case study building is calculated with a dynamic simulation tool, EnergyPlus. Afterwards, a sort of architectural energy efficient measures is implemented in the envelope while the lighting and mechanical systems remain constant. The energy used in the production and transportation of materials, which are the significant parts of the embodied energy, are taken into account as well.

Recast version of Energy Performance of Building Directive (EPBD-Recast) obligate member states to keep the cost analysis in parallel with the energy analysis during the renovation actions for the existing building by taking the cost-optimal level of minimum energy performance requirement to the account. Although this cost-optimal level is indicating the minimum cost level for a period, it can provide buildings’ owners with an enormous initial cost. One of the most challenging barriers to energy efficient and cost-optimal renovation of existing buildings is the reluctance of owners to involve in their project as an investor due to the high cost of application. Particularly in developing countries, such reluctance is more tangible as the governments are not capable of providing enough financial incentives for owners due to a large number of buildings that should be renovated and small available budget. A proper solution for the problem is to divide necessary actions for each building to certain sub-actions and apply them as a step-by-step renovation project. On the other hand, the progressive application of renovation activities has some restrictions. It is necessary to define the due amount for households and keep the cost of each step within the payable range. Moreover, the low rate of building renovation which affects the EU goals can be improved remarkably by application of step-by-step actions not only by increasing the number of owners’ contributions but also by improving the time of implementation, proper distribution of skilled labours and directed economic resources. This paper aims to assess the step-by-step application of the energy efficient renovation actions through energy and cost analysis under Turkey’s climatic, economic and sociological conditions. One of 26 reference residential buildings in Turkey is analysed in this paper. The due amount for each step is defined, and some renovation actions and their combinations applied to the case building and the results compared with the base condition. Then a proper combination of measures established based on the cost-optimal analyses. These appropriately combined actions are then divided into some sub-actions; following this, cost and energy studies are conducted again to determine the appropriate arrangement of sub-actions.

Objective: There are some concerns regarding long-term complications of COVID-19 in children. A systematic review and meta-analysis was performed evaluating the respiratory symptoms and pulmonary function, post-SARS-CoV-2 infection., Methods: A systematic search was performed in databases up to 30 March 2023. Studies evaluating respiratory symptoms and pulmonary function after COVID-19 infection in children were selected. The major outcomes were the frequency of respiratory symptoms and the mean of spirometry parameters. A pooled mean with 95% confidence intervals (CIs) was calculated., Results: A total of 8 articles with 386 patients were included in meta-analysis. Dyspnea, cough, exercise intolerance, and fatigue were the most common symptoms. The meta-mean of forced expiratory volume (FEV1) and forced vital capacity (FVC) was 101.72%, 95% CI= (98.72, 104.73) and 101.31%, 95% CI= (95.44, 107.18) respectively. The meta-mean of FEV1/FVC and Forced expiratory flow at 25 and 75% was 96.16%, 95% CI= (90.47, 101.85) and 105.05%, 95% CI= (101.74, 108.36) respectively. The meta-mean of diffusing capacity for carbon monoxide was 105.30%, 95%CI= (88.12, 122.49). There was no significant difference in spirometry parameters before and after bronchodilator inhalation., Conclusions: Despite some clinical respiratory symptoms, meta-results showed no abnormality in pulmonary function in follow-up of children with SARS-CoV-2 infection. Disease severity and asthma background had not confounded this outcome., (© 2024. The Author(s).)

Angiotensin receptor blockers (ARBs) are commonly prescribed in pediatric hypertension because of the fundamental role of the renin-angiotensin-aldosterone system in the pathogenesis of hypertension. We, therefore, aimed to systematically review articles that investigated efficacy and safety of ARB agents in the pediatric population aged over six years. To do so, the databases of Web of Science, PubMed/MEDLINE, and Scopus were searched to conduct a systematic review by using the following keywords: ("angiotensin receptor blocker" OR "valsartan" OR "losartan") AND ("pediatric" OR "children" OR "child") AND ("high blood pressure" OR "hypertension"). Finally, 12 studies were included in our review, and we found that almost all of them supported the effectiveness and tolerability of different ARB agents. Candesartan cilexetil lowered blood pressure (BP), with a 9 mmHg decline in both systolic and diastolic BP, and proteinuria after four months of treatment. Valsartan and Losartan similarly were shown to be effective in lowering BP in a dose-dependent manner. Headache, dizziness, upper respiratory infection, and cough were the most reported side effects. However, almost all reviewed studies indicated that the safety profile was satisfactory. In conclusion, ARBs are beneficial and well-tolerated antihypertensive medications.  DOI: 10.52547/ijkd.7228.

Genetic defects in the development, maturation, and/or function of the immune cells can lead to Inborn errors of immunity (IEI) which may predispose patients to malignancies. The overall risk for cancer in children with IEI ranges from 4 to 25% and the type of malignancy is highly dependent on the specific mutant gene underlying IEI. We investigated 3056 IEI patients registered in the Iranian national registry between the years 1999 and 2020 in this retrospective cohort study. The frequency of malignancy and its association with the type of IEI in these patients were evaluated. A total of 82 IEI patients with malignancy were enrolled in this study. Among them, predominantly lymphoma was the most common type of malignancy (67.1%), followed by leukemia (11%), and cancers of the head and neck (7.3%). Among identified lymphoma cancers, non-Hodgkin's lymphomas were the most frequent type (43.9%) followed by different subtypes of Hodgkin's lymphoma (23.2%). Solid tumors (18.3%) appeared to be very heterogeneous by type and localization. The correlation between the type of malignancy and survival status and the association between the type of malignancy and IEI entities were unremarkable. The awareness of the association between the presence of IEI and cancer highlights the importance of a synergistic effort by oncologists and immunologists in the early diagnosis of malignancy and personalized therapeutic strategies in IEI patients., (© 2022. The Author(s).)

Probiotics are defined as "live microorganisms that confer a health benefit on the host when administered adequately." In recent years, the cosmetic industry has tried to develop many products classified as probiotics. They can exert their benefits at the skin level because of their favorite properties, and they could prevent and treat skin diseases and represent an emerging area for skin health. The antibacterial and immunomodulatory properties make them promising candidates to target skin disorders including acne, psoriasis, and atopic dermatitis and aid wound healing. The scientific reports show that specific probiotic strains can modulate cutaneous microflora, skin immune system, lipid barrier, and skin health preservation. This review summarizes the most relevant evidence from scientific literature concerning potential topical applications of probiotics in dermatology. Altogether, the evidence reported here affords the possibility of designing new strategies based on a topical approach to prevent and treat cutaneous disorders., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

The new emerging virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causes a huge burden of morbidity and mortality worldwide. One of the predisposing factors which might increase the infection susceptibility and its complications can be the Inborn Errors of Immunity (IEI). One hundred and seventeen primary immunodeficient (PID) pediatric patients were monitored from March to December 2020 for any signs and symptoms of SARS-CoV-2 infection. Among them twenty-eight children were symptomatic and nineteen out of the twenty-eight patients took the coronavirus PCR test. Out of them, the PCR test results of 9 patients were positive. Herein, we report the nine cases of pediatric patients with IEI who were also infected with SARS-CoV-2 with a positive PCR test. We observed a variation in clinical manifestations, clinical courses, and outcomes among IEI pediatric patients affected with COVID-19. In our survey, prompt diagnosis and appropriate monitoring for possible complications were shown to be effective in reducing the mortality rate of the SARS-CoV-2 affected patients with IEI. Although there is no approved treatment for SARS-CoV-2 infection, supportive treatment might reduce the complications and lead to better outcomes. This study received approval from the Research Ethics Committee of Mashhad University of Medical Science with the ethics code of IR.MUMS.REC.1399.155. (https://ethics.research.ac.ir/EthicsProposalViewEn.php?id=129963)., Competing Interests: None., (AJCEI Copyright © 2021.)

BACKGROUND Celiac disease is a non-IgE mediated food allergy, which can cause extensive villus atrophy. Because of increased food allergen absorption, there are elevated IgA and IgG antibodies in these patients, so there is a concern about IgE antibody production against wheat and other cereals. METHODS In this study, we evaluated IgE-mediated hypersensitivity to wheat, rice, and other cereals in children with celiac disease. RESULTS 22 patients (50%) had at least one positive skin prick test to food allergens. The most frequent food allergen was peanut (31.8%), followed by wheat (18.2%), corn (9.1%), and rice (4.5%). The results revealed no significant correlation between age, sex, and the results of the skin prick test ( p >0.05). The correlation between diagnosis time of celiac disease and results of skin prick test was also not significant statistically ( p >0.05). CONCLUSION Because of the high prevalence of IgE mediated hypersensitivity to cereals and beans in children with celiac disease, a skin prick test might be considered in these patients, especially in refractory cases., Competing Interests: CONFLICT OF INTEREST The authors declare no conflict of interest related to this work, (© 2021 The Author(s).)

Background: Intravenous immunoglobulins (IVIg) are the major treatment in inborn errors of immunity (IEI) disorders; However, IVIg infusions show some adverse effects. We aimed to assess the adverse reactions of IVIg infusions., Methods: Data of IVIg infusions in IEI patients were collected from 2011 to 2021. Totally, 363 IEI patients received IVIg regularly in Iran entered the study. The adverse reactions are classified regarding their severity and chronicity., Results: 22,667 IVIg infusions were performed in the study. 157 patients (43.2%) and 1349 (5.9%) infusions were associated with at least one type of adverse reaction. The highest rates of adverse reactions were seen in severe combined immunodeficiency. Myalgia, chills, headache, fever, and hypotension were the most frequent adverse effects of IVIg., Conclusion: The reactions affect almost half of the patients mainly in the first infusions which necessitate the close observation of IEI patients receiving IVIg., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Although it is estimated that COVID-19 life-threatening conditions may be diagnosed in less than 1:1000 infected individuals below the age of 50, but the real impact of this pandemic on pediatric patients with different types of primary immunodeficiency (PID) is not elucidated. The current prospective study on a national registry of PID patients showed that with only 1.23 folds higher incidence of infections, these patients present a 10-folds higher mortality rate compared to population mainly in patients with combined immunodeficiency and immune dysregulation. Therefore, further management modalities against COVID-19 should be considered to improve the survival rate in these two PID entities using hematopoietic stem cell transplantation and immunomodulatory agents.

Background: Severe Acute Respiratory Syndrome Coronavirus 2 has affected millions of people, and especially in adult patients with underlying diseases lead to death. Meanwhile pediatric patients with inherited defects of T cell should be prone to viral diseases., Case Presentation: Herein, we report an infant with severe combined immunodeficiencies, who were affected and died because of COVID-19., Conclusion: Considering the importance of finding how immune system can affect the viral infection, presentation of COVID-19 in immune deficient patients can be valuable., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

The prevalence of multisystem inflammatory syndrome in children (MIS-C) has increased since the coronavirus disease 2019 (COVID-19) pandemic started. This study was aimed to describe clinical manifestation and outcomes of MIS-C associated with COVID-19. This systematic review and meta-analysis were conducted on all available literature until July 3rd, 2020. The screening was done by using the following keywords: ("novel coronavirus" Or COVID-19 or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus) and ("MIS-C" or "multisystem inflammatory" or Kawasaki). Data on gender, ethnicity, clinical presentations, need for mechanical ventilation or admission to intensive care unit (ICU), imaging, cardiac complications, and COVID-19 laboratory results were extracted to measure the pooled estimates. Out of 314 found articles, 16 articles with a total of 600 patients were included in the study, the most common presentation was fever (97%), followed by gastrointestinal symptoms (80%), and skin rashes (60%) as well as shock (55%), conjunctivitis (54%), and respiratory symptoms (39%). Less common presentations were neurologic problems (33%), and skin desquamation (30%), MIS-C was slightly more prevalent in males (53.7%) compared to females (46.3%). The findings of this meta-analysis on current evidence found that the common clinical presentations of COVID-19 associated MIS-C include a combination of fever and mucocutaneous involvements, similar to atypical Kawasaki disease, and multiple organ dysfunction. Due to the relatively higher morbidity and mortality rate, it is very important to diagnose this condition promptly.

Brain tumors are the rarest cause of cerebrospinal fluid rhinorrhea. Non-traumatic cerebrospinal fluid rhinorrhea is also a relatively rare condition. It may be misdiagnosed as allergic rhinitis or chronic sinusitis and lead to unsuitable treatment. We described a 34-year-old man who came to our allergy clinic with a chief complaint of clear rhinorrhea from his left nostril with more than four years of duration. Onlyhypertrophy of left inferior concha was found in the clinical examination. His rhinorrhea aggravated when bending forward. So we were suspicious of CSF rhinorrhea. MRI was done for him and demonstrated a large tumor in the pineal region. The patient underwent surgery with resection of the mass via an infratentorial-supracerebellar approach. This case showed the role of maintaining differential diagnosis for a common complaint; rhinitis which is seen as usual.

New emerging viruses like coronavirus 2019 (COVID-19) infections are always frightening. We know little about their transmission, behaviors, clinical manifestations, and outcomes. There is no vaccine or therapeutic strategies to deal with these infections yet. In this situation, preventive measures may be promising. Hand hygiene is a very important issue in preventing viral infection; however, there are other entities that can enhance the immune response and help in infection prevention. Herein we review some measures for boosting the immune system.

Background: Allergic Rhinitis (AR) is the most common allergic disease worldwide. The present study, evaluated effects of synbiotic on gene expression of interferon-gamma (IFN-γ), interleukin-4 (IL-4), interleukin-10 (IL-10), interleukin-17 (IL-17), transforming growth factor beta (TGF-β), and forkhead box P3 (FoxP3) in AR patients who received concomitant immunotherapy in a placebo-controlled clinical trial., Materials and Methods: Twenty AR patients were randomized in synbiotic and placebo groups and received cluster immunotherapy for 2 months. RNA was extracted from peripheral PBMCs, then the cDNA synthesized. Subsequently, SYBR Green real-time Reverse transcription polymerase chain reaction technique was employed for studying the expression of mentioned genes. In addition, SNOT-22 and mini-Rhinoconjunctivitis Quality of Life Questionnaire questionnaires were completed by patients. Data were analyzed before and also 2 and 6 months after intervention., Results: Clinical symptoms and quality of life were improved with immunotherapy, but there was no significant difference between the placebo and synbiotic groups. Gene expression of IFN-γ, TGF-β, and FoxP3 was increased whereas the gene expression of IL-4 and IL-10 decreased, but not significant. Interestingly, the gene expression of IL-17 in the synbiotic group was significantly decreased versus placebo after 2 months ( P = 0.001) and also at the end of intervention ( P = 0.0001) comparing with the time zero., Conclusion: Significant reduction in the IL-17 gene expression following administration of synbiotic versus placebo shows the importance of synbiotic in control of the immunopathogenesis of AR. Further studies with more samples are recommended. In addition, evaluating the effects of synbiotic in patients who do not undergo immunotherapy is suggested to get a better conclusion., Competing Interests: There are no conflicts of interest.

Background: The most common malignancy of children is Leukemia, accounting approximately one third of cancer diagnosis. Available data demonstrate improvement in survival of pediatric leukemia, so evaluation of side effects of treatment is very important. This study investigates hyperglycemia and diabetes mellitus prevalence in pediatric patients with acute leukemia., Materials and Methods: This study was performed in children with acute leukemia. At the first admission, demographic data was collected and blood glucose and HbA1c levels were obtained. These tests examined at least two times during six months of follow up. Growth parameters and blood samples were obtained too., Result: Twenty nine patients were examined; three of them (10.3%) had diabetes mellitus and 5patients (17.2%) had transient hyperglycemia.Mean age of the patients was 6.26 years and nineteen Children (63%) were in preschool age. In preschool age children, incidence of hyperglycemia was meaningfully higher than school age children (p= 0.02). 24 of 29 patients (82.7%) were known case of acute lymphoblastic leukemia (ALL) and 5 patients (17.3%) were known case of acute myeloblastic leukemia (AML). No significant difference was found between sex groups. Also underweight was significant risk factor for hyperglycemia., Conclusion: The prevalence of hyperglycemia was in the range of other similar studies in different parts of the world. Underweight and preschool ages were significant predictors of hyperglycemia.