Translational Health Reports

Abstract Background: Renal peripelvic (parapelvic) cysts cause hydronephrosis, pain, and obstruction when exceeding 4-5 cm due to hilar compression, with elevated IL-6, TNF-α, and creatinine reflecting inflammation and impaired function.​
Objective: This narrative review synthesizes evidence on pathophysiology, diagnosis, and minimally invasive management, emphasizing retroperitoneoscopic decortication versus ureteroscopic drainage outcomes.​
Methods: Literature from 2011-2025 (PubMed, Scopus, Web of Science) was reviewed, prioritizing comparative studies, case series (n≥20), and biomarker data; a key 100-patient cohort provided head-to-head analysis.​
Results: Retroperitoneoscopic decortication shows superior outcomes versus ureteroscopy: shorter operative time (78±18 vs 112±24 min), less blood loss (25±15 vs 55±30 mL), faster recovery (hospital stay 2.8±0.9 vs 5.1±1.4 days), lower complications (8% vs 18%), and greater IL-6/TNF-α decline; recurrence rates similar (8-10%).​
Conclusion: Retroperitoneoscopic decortication is optimal for symptomatic peripelvic cysts, balancing efficacy, safety, and biomarker recovery over ureteroscopy

Abstract Background: Pediatric kidney transplantation is the optimal therapy for end-stage kidney disease in children, yet long-term allograft survival remains inferior to adults due to heightened immunological reactivity, subclinical inflammation, and progressive fibrosis. Conventional monitoring with serum creatinine and protocol biopsies is limited by poor sensitivity and invasiveness.
Methods: This comprehensive narrative review synthesizes evidence on native T1-mapping MRI—a non-contrast technique quantifying renal parenchymal microstructure via elevated cortical T1 and reduced corticomedullary differentiation, reflecting inflammation, oedema, and interstitial fibrosis/tubular atrophy (IFTA)—and its mechanistic interplay with serum cytokine/chemokine profiles capturing alloimmune response phenotypes.
Results: Emerging data show strong pathophysiological/statistical correlations between pro-inflammatory cytokines (especially IL-6, TNF-α, CXCL10) and T1 prolongation, as cytokine-driven inflammation alters tissue relaxation properties detectable by MRI. Native T1-mapping demonstrates high diagnostic performance for IFTA (sensitivity 81-89%, specificity 78-85%), predicts graft dysfunction (HR 3.8 per 100 ms T1 increase), and tracks treatment response. Combined with cytokines, it identifies subclinical rejection with 94% specificity, outperforming eGFR/creatinine.
Conclusions: Native T1-mapping offers robust prognostic value in pediatric renal allografts. Integrated with targeted cytokine panels, it enables biopsy-sparing monitoring, early injury detection, and personalized strategies to improve outcomes. Multicenter trials with standardized protocols are needed.

Abstract Introduction: Chronic neck pain (CNP) is a common and debilitating condition that significantly impacts quality of life, productivity, and overall well-being. Muscle morphology, particularly in the deep cervical muscles, plays a critical role in the onset, development, and persistence of chronic neck pain. This review investigates the relationship between muscle changes, including atrophy, fat infiltration, and alterations in muscle fiber composition, and their contribution to cervical instability, pain, and functional limitations.

Methods: The review examines existing literature on muscle morphology in CNP, focusing on the role of deep cervical muscles in the pathophysiology of neck pain. It also highlights how factors such as disuse, changes in neural activation, and chronic inflammation exacerbate these muscle alterations. The role of advanced imaging techniques, such as MRI, in identifying these changes is also discussed.

Results: Alterations in muscle morphology, including atrophy and fat infiltration, contribute to weakness and reduced spinal stability, which are key factors in the development and persistence of chronic neck pain. Neural activation changes and chronic inflammation further exacerbate muscle degeneration. Advanced imaging techniques, particularly MRI, play a crucial role in assessing these morphological changes and enabling personalized treatment strategies.

Conclusion: Muscle degeneration, including atrophy and fat infiltration in the cervical spine, is a significant factor in chronic neck pain. Effective management requires a comprehensive approach, including rehabilitation programs focused on muscle strengthening, postural correction, and ergonomic adjustments. Fat infiltration in cervical muscles is a significant marker of structural and functional impairment in cervical spine disorders. Further research is needed to explore the mechanisms behind muscle changes in CNP and to develop more targeted and effective interventions.

Abstract Introduction: Plantar fasciitis is a prevalent condition characterized by chronic heel pain, primarily caused by inflammation of the plantar fascia. The condition significantly impairs daily activities and quality of life, presenting a challenge for healthcare providers. Numerous treatment modalities, ranging from conservative measures to invasive interventions, have been explored to manage the symptoms and promote healing. However, the effectiveness of these treatments, especially when combined, requires further evaluation.

Methods: This review extracted data from existing studies comparing the effectiveness of corticosteroid injections (CSI) alone versus their combination with needling techniques (such as dry needling and percutaneous needle electrolysis) for chronic plantar fasciitis. The literature was assessed through systematic reviews, randomized controlled trials, and clinical studies that evaluated pain relief, functional recovery, and long-term outcomes. Studies on adjunctive treatments like extracorporeal shockwave therapy (ESWT) were also considered to provide a broader comparison.

Results: Corticosteroid injections provide significant short-term pain relief but are limited in their long-term efficacy, with potential complications like tissue atrophy. Dry needling and other needling therapies, when used in combination with CSI, have shown improved long-term outcomes in terms of pain reduction and functional recovery. ESWT consistently outperformed other treatments in long-term studies for both pain management and functional improvement. Combining treatments appears to yield enhanced results, although conclusive evidence on optimal treatment protocols remains insufficient.

Conclusion: Chronic plantar fasciitis requires a multi-faceted treatment approach. While corticosteroid injections remain a common short-term solution, combining them with needling techniques may offer superior long-term benefits. Extracorporeal shockwave therapy also shows promise for sustained relief. Further research is needed to establish optimal treatment protocols and to better understand the combined effects of these interventions. An individualized treatment strategy that addresses both symptoms and underlying causes is essential for improving patient outcomes.

Abstract Leptospirosis is a globally distributed zoonotic infection, more prevalent in tropical and low-income regions due to high temperatures, humidity, rainfall, and poor socioeconomic conditions. Individuals in high-risk occupations, such as farmworkers, veterinarians, and slaughterhouse employees, are particularly vulnerable. Early symptoms include fever, headache, myalgia, and conjunctival inflammation. Prompt diagnosis via culture and agglutination tests, along with early antibiotic treatment, can reduce complications and speed recovery. Adhering to hygiene and workplace safety measures is crucial for infection prevention and control.

This report presents the case of a 45-year-old male with fever, jaundice, and multiple systemic symptoms, with a history of chronic kidney disease and recent rice paddy exposure. He was admitted to Razi Hospital in Qaemshahr, where his condition rapidly deteriorated, requiring multidisciplinary intervention from nephrology, infectious disease, pulmonology, and psychiatry specialists. Initial findings revealed severe thrombocytopenia (platelet count: 8,000) and elevated creatinine levels (6 mg/dL), prompting treatment with dexamethasone, ceftriaxone, fluid therapy, and dialysis. However, his worsening respiratory distress and alveolar bleeding led to ICU admission.

Leptospirosis was suspected based on occupational exposure and was confirmed by positive IgM antibodies in urine PCR. Despite intensive interventions—including dialysis, pleural fluid drainage, and Shaldon catheter placement—the patient developed progressive pulmonary complications and eventually succumbed.

This case highlights the diagnostic and management challenges of leptospirosis in a patient with preexisting comorbidities. It underscores the importance of a multidisciplinary approach in recognizing and addressing the complexities of infectious diseases in critical care settings.

Abstract Introduction: Osteoporosis is a widespread bone disease characterized by low bone mineral density (BMD), structural bone deterioration, and an increased risk of fractures. It primarily affects postmenopausal women and the elderly, representing a significant global health burden. The management of osteoporosis involves pharmacological treatments aimed at preventing fractures, alleviating symptoms, and improving overall quality of life.
Methods: This review analyzes the pharmacology of current osteoporosis treatments, including bisphosphonates, selective estrogen receptor modulators (SERMs), monoclonal antibodies, and newer agents such as sclerostin inhibitors. It also examines pain management strategies, particularly those targeting fracture-related pain, and explores the intersection between bone therapies and analgesia.
Results: The current pharmacological treatments for osteoporosis have shown significant efficacy in reducing fracture risk. However, managing pain in osteoporosis, particularly post-fracture pain, remains a complex challenge. This review highlights the need for a multidimensional approach that integrates both bone-targeted therapies and effective pain management strategies.
Conclusion: While osteoporosis therapies have greatly reduced fracture risk, pain management in osteoporosis patients remains an area requiring further research. This review synthesizes current literature on osteoporosis treatments and pain management, offering insights into best practices and identifying future research directions to improve patient outcomes.

Abstract Urosepsis is a severe, life-threatening condition caused by the rapid dissemination of urinary-tract pathogens into the bloodstream and an uncontrolled host inflammatory response. The emergence of multidrug-resistant organisms and the variability of immune activation in critically ill patients have made its management increasingly complex. Targeted antimicrobial therapy (TAT)—defined as the selection of antibiotics based on microbiological identification and susceptibility testing—embodies the principles of precision medicine, aiming to optimize treatment effectiveness while minimizing broad-spectrum exposure and the spread of resistance.

This review synthesizes the current evidence regarding the role of TAT in urosepsis, highlighting its effects on systemic inflammation, organ function, and clinical outcomes. Special attention is given to novel biomarkers such as Presepsin, neutrophil CD64 index, and Copeptin, examined alongside classical inflammatory mediators including tumour necrosis factor-α (TNF-α), interleukin-6 (IL-6), and C-reactive protein (CRP). Collectively, these markers provide valuable insights into the interplay between pathogen control and immune modulation. The review also discusses diagnostic and operational barriers to implementing TAT, the variability of antimicrobial stewardship across institutions, and future research directions aimed at integrating biomarker-guided targeted therapy into individualized sepsis management.

Abstract Background: Spinal injuries are a significant cause of morbidity and mortality globally. Trauma-related spinal fractures contribute to the burden on healthcare systems and significantly affect the quality of life. Although substantial progress has been made in trauma care, spinal fractures, particularly those associated with spinal cord injuries (SCI), remain a leading cause of long-term disability. The epidemiology of spinal fractures varies regionally due to demographic, trauma mechanisms, and healthcare factors. In Iran, motor vehicle accidents and falls from heights are prominent causes of spinal injuries, but regional data on the epidemiology of these injuries, particularly from smaller cities, is scarce.


Materials and Methods: This retrospective cohort study was conducted at Imam Khomeini Hospital in Sari, Mazandaran province, Iran, reviewing the records of 288 patients with spinal fractures treated between March 2014 and March 2018. Data collected included demographic characteristics (age and gender), injury mechanisms, fracture locations, fracture types, presence of spinal cord injuries, and clinical outcomes. The analysis also included the association between injury mechanisms and fracture types using statistical tests.


Results: The study included 288 patients, with 75% being male and a mean age of 39.21 years. The most common mechanisms of injury were motor vehicle accidents (47.2%) and falls from height (35.4%). Cervical spine fractures were the most common, accounting for 49% of cases. Burst fractures were the most prevalent type of fracture (40.5%). Spinal cord injuries were present in 21.2% of the patients, with a higher incidence in those injured by vehicle accidents. The mortality rate was 3.1%, and 42.4% of patients underwent surgical intervention. The average hospital stay was 7.53 days.


Conclusion: This study provides a comprehensive epidemiological profile of spinal fractures in a regional Iranian hospital. It highlights the high incidence of spinal fractures due to motor vehicle accidents and falls from height, with cervical spine fractures and burst fractures being the most common. The presence of spinal cord injury is significant and underscores the need for early diagnosis and effective treatment. . Further studies, particularly prospective ones, are needed to better understand the long-term outcomes of spinal injuries and SCI in Iran.