Diagnostic accuracy of ESR1 mutation detection by cell-free DNA in breast cancer: a systematic review and meta-analysis of diagnostic test accuracy.

BACKGROUND: Estrogen receptors express in nearly 70% of breast cancers (ER-positive). Estrogen receptor alpha plays a fundamental role as a significant factor in breast cancer progression for the early selection of therapeutic approaches. Accordingly, there has been a surge of attention to non-invasive techniques, including circulating Cell-free DNA (ccfDNA) or Cell-Free DNA (cfDNA), to detect and track ESR1 genotype. Therefore, this study aimed to examine the diagnosis accuracy of ESR1 mutation detection by cell-free DNA in breast cancer patientsthrough a systematic review and comprehensive meta-analysis. METHODS: PubMed, Embase, and Web of Science databases were searched up to 6 April 2022. Diagnostic studies on ESR1 measurement by cfDNA, which was confirmed using the tumour tissue biopsy, have been included in the study. The sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were considered to analyse the data. RESULTS: Out of 649 papers, 13 papers with 15 cohorts, including 389 participants, entered the meta-analyses. The comprehensive meta-analysis indicated a high sensitivity (75.52, 95% CI 60.19-90.85), specificity (88.20, 95% CI 80.99-95.40), and high accuracy of 88.96 (95% CI 83.23-94.69) for plasma ESR1. We also found a moderate PPV of 56.94 (95% CI 41.70-72.18) but a high NPV of 88.53 (95% CI 82.61-94.44). We also found an NLR of 0.443 (95% CI 0.09-0.79) and PLR of 1.60 (95% CI 1.20-1.99). CONCLUSION: This systematic review and comprehensive meta-analysis reveal that plasma cfDNA testing exhibits high sensitivity and specificity in detecting ESR1 mutations in breast cancer patients. This suggests that the test could be a valuable diagnostic tool. It may serve as a dependable and non-invasive technique for identifying ESR1 mutations in breast cancer patients. However, more extensive research is needed to confirm its prognostic value.

Subacute thyroiditis after SARS-CoV-2 vaccination: A case report.

Key Clinical Message: Subacute thyroiditis which is typically characterized by cervical pain and fever is caused by viral infection and is seen after SARS-CoV-2 vaccination. Here we report a post-vaccination subacute thyroiditis after SARS-CoV-2 vaccination. Abstract: Subacute thyroiditis (SAT) is possibly caused by a viral infection and is typically characterized by cervical pain and fever. SAT associated with SARS-CoV-2 infection or SARS-CoV-2 vaccination has been reported, albeit in limited numbers. A 34-year-old woman was referred to our clinic with typical SAT symptoms. The diagnosis was confirmed through thyroid scintigraphy after receiving the SARS-CoV-2 vaccination, despite testing negative for COVID-19 via RT-PCR. There is a theoretical correlation between SARS-CoV-2 vaccination and SAT. Vaccination may have a direct or indirect impact on the thyroid, but further studies are required to confirm this relationship. A systematic review of the literature of similar cases was performed for comparison. Ultimately, the overall benefits of SARS-CoV-2 vaccination outweigh the potential adverse effects. Therefore, these types of reports should not divert attention from the actual reality.

Renal aspergillosis after COVID-19-associated pulmonary aspergillosis: A case report.

Key Clinical Message: Renal aspergillosis is a rare condition and this case the first case of Renal aspergillosis reported after COVID-19-associated pulmonary aspergillosis. Renal symptoms should arise clinical suspicion to renal involvement that happened as a result of hematogenous spreading of pulmonary aspergillosis. Abstract: Secondary fungal infections are among the most significant complications that can arise after COVID-19 and have the potential to lead to a high rate of morbidity and mortality. As COVID-19 primarily involves the airway, the majority of fungal infections reported have been related to the respiratory system. However, renal aspergillosis that we have reported is a rare condition that also can occur. A 67-year-old man was referred to our hospital and admitted as a COVID-19 patient. After the initial recovery, he experienced a recurrence of fever accompanied by a productive cough. The histopathological studies were conducted on the sputum and bronchoalveolar lavage samples, which revealed the presence of Aspergillus flavus. We treated the patient with voriconazole and the patient was discharged after a period of time. However, after approximately 6 months, he returned to the hospital with a fever and abdominal pain. We started a fever workup. Two new hypoechoic abscess-like masses were spotted in the right kidney in the ultrasonography (U/S) and the direct molecular studies of the biopsy sample obtained under U/S guidance identified Aspergillus flavus. Although renal aspergillosis is a rare condition, it should not be overlooked, especially in patients with severe COVID-19 and pulmonary aspergillosis, as these conditions can lead to renal aspergillosis, which may present with symptoms such as abdominal pain with fever. Therefore, it is necessary to perform radiological and histopathological studies when renal aspergillosis is suspected.

MicroRNA-372 acts as a double-edged sword in human cancers.

MicroRNAs (miRNAs or miRs) are non-coding, single-stranded, endogenous RNAs that regulate various biological processes, most notably the pathophysiology of many human malignancies. It process is accomplished by binding to 3'-UTR mRNAs and controlling gene expression at the post-transcriptional level. As an oncogene, miRNAs can either accelerate cancer progression or slow it down as a tumor suppressor. MicroRNA-372 (miR-372) has been found to have an abnormal expression in numerous human malignancies, implying that the miRNA plays a role in carcinogenesis. It is both increased and downregulated in various cancers, and it serves as both a tumor suppressor and an oncogene. This study examines the functions of miR-372 as well as the LncRNA/CircRNA-miRNA-mRNA signaling pathways in various malignancies and analyses its potential prognostic, diagnostic, and therapeutic implications.

Tuberculosis infection among children under six in contact with smear positive cases: A study in a hyper endemic area of Iran.

Introduction: Annually, tens of millions of children are being exposed to tuberculosisinfection. Note that children are in higher risk of getting infection and sever types of the disease, detecting the factors associated with transmission of the tuberculosis infection and disease to the exposed children is necessary for disease prevention within the community. Methods: In this retrospective cohort study, 50 children under 6 who were in close contact with 25 smear-positive pulmonary tuberculosis cases in Sistan-Baloochistanprovine, Iran, were investigated. Demographic, behavioral and clinical characteristics of children and index cases were collected and tuberculosis infection and disease was assessed using the WHO guidelines. Results: Of 50 children exposed to the active cases, 12 (24 %) were infected to tuberculosis but none of them had active disease. We also found significant associations of the history of diabetes mellitus in the index cases (p = 0.043) and large family size (p = 0.026) with the increased risk of infection among the exposed children. Conclusion: Children under six which are in close contact with diabetic tuberculosis cases in large families are in higher risk of getting infection.

Suicide attempt using zinc phosphide rodenticide: A case report and literature review.

The patients with a history of intentional or unintentional consumption of rodenticide compounds, especially ZnP, it is necessary to assess ABG and abdominal radiography.

The over diagnosed COVID-19 infection in an adult patient with foreign body aspiration.

INTRODUCTION AND IMPORTANCE: Foreign body aspiration (FBA) in adults may be asymptomatic or symptomatic. Fever and cough are the most common symptoms of Coronavirus infection and other causes of pneumonia. Regardless of the etiology of pneumonia, the first step in the treatment of FBA-associated pneumonia is to remove the foreign body from the airway. CASE PRESENTATION: A 32-year-old man was referred to our emergency department on October 26, 2020 with shortness of breath (SOB) and a cough. He was referred to the medical center with clinical suspicion of Coronavirus disease-19 (COVID-19), and his disease was treated considering COVID-19. Based on the persistence of his symptoms after discharge, he was referred to the hospital again, and the presence of a foreign body was confirmed by a rigid bronchoscopy, which was then removed. CLINICAL DISCUSSION: Our patient did not remember any history of aspirating solid particles, choking, or any other high-risk conditions associated with aspiration. Also, he had no symptoms with the exception of cough and SOB before the first admission. It means that asymptomatic FBA can be tolerated and go undiagnosed, particularly in adults, and manifests as a secondary complication, such as pneumonia. CONCLUSION: The FBA and other causal agents may mimic COVID-19 pneumonia. Consequently, FBA should be included in the COVID-19 differential diagnosis.