Single Nucleotide Polymorphism rs6445975 in the PXK Gene Is Correlated with Susceptibility and Clinical Characteristics of Systemic Lupus Erythematosus.

Background: Recently, genome-wide association studies (GWAS) have discovered several single nucleotide polymorphisms (SNPs) and loci associated with the risk of systemic lupus erythematosus (SLE). rs6445975 (T>G; intronic variant) polymorphism in the PXK gene is one of these loci. However, there was an inconsistency between the results of replicative studies on European and Asia ancestry. This study aimed to assess the possible association between rs6445975 polymorphism with SLE risk in the Iranian population. Methods: Genotype and allele distribution of rs6445975 polymorphism were investigated in 110 patients with SLE and 115 healthy controls in Isfahan University of Medical Sciences, Isfahan, Iran in 2019 via real-time PCR high resolution melting method (HRM). Results: GG and TG genotypes, but not TT genotype, were associated with increased risk of SLE (GG vs TT; OR= 7.538; 95%CI [3.47, 17.066] and TG vs TT; OR=2.21; 95%CI [1.06, 4.72]). Inheritance analysis revealed that TG + GG was correlated with the increased risk of SLE disease in the dominant model (OR=3.928; 95%CI [2.056, 7.74]). Moreover, subjects with the G allele were more frequently affected with SLE than individuals with the T allele (OR= 3.55; 95%CI [2.37, 5.36]). The G allele in patients was correlated with serum concentration of CRP, ESR, anti-dsDNA antibody, C3, and C4 and presentation of some clinical manifestations such as kidney involvements and skin lesions (P<0.05). Conclusion: Our findings suggest a substantial association between rs6445975 polymorphism in the PXK gene with susceptibility and clinical characteristics of SLE in the Iranian population.

Cardiogenic Shock and Guillain-Barré Syndrome as the First Manifestations of Pheochromocytoma.

Febrile congestive heart failure is a rare first manifestation of pheochromocytoma. Herein, the case of a 31-year-old female with febrile congestive heart failure and subsequent cardiogenic shock is presented. After intensive care unit (ICU) admission and further evaluating the right adrenal mass observed in abdominal ultrasonography, the diagnosis of pheochromocytoma was confirmed. Then, she was scheduled for the right adrenalectomy. Before surgery, she complained of acute-onset progressive muscle weakness in the lower limbs, followed by the upper limbs. After further investigation, she was diagnosed with Guillain-Barré syndrome and treated with intravenous immunoglobulin (IVIG). She recovered well after the right adrenalectomy, and during the subsequent 18 months, the follow-up did not reveal any complications, and left ventricular function recovered to normal.

Case Report: Barotrauma in COVID-19 Case Series.

Severe acute respiratory syndrome coronavirus 2 can cause pulmonary complications, such as increased risk of barotrauma (BT), but its prevalence and risk factors are not known. In this case series, the course of BT and its related risk factors were discussed in patients with COVID-19 who were admitted to the intensive care unit. Medical records of the patients with COVID-19 and BT and hospitalized in the intensive care unit for 5 months were extracted. The course of BT and its possible associated risk factors are descriptively presented. Among 103 patients with COVID-19 who were intubated, 13 patients (12.6%) had BT. One patient developed BT before intubation. All patients with BT were male. Half of them developed BT in the first 5 days of intubation. Eight patients (61.53%) had a positive culture for Klebsiella pneumoniae. Nine patients (69.9%) died. High positive end-expiratory pressure, coinfection with bacterial pneumonia, and history of lung disease may affect BT incidence. The treatment team should increase their upervision on the ventilator setting, especially in the first week of intubation.

Predictors of smoking cessation and duration: implication for smoking prevention.

BACKGROUND: There are few articles studding the factors associated with successful smoking cessation in Iranian smokers. The aim of this study is to clarify the association between socio-demographic factors and smoking behavior, such as number of failed smoking cessation and duration of abstinence in Iranian population. METHODS: A self-administered questionnaire survey of 673 participants was conducted in a local government health-care center. The questionnaire included items on socio-demographic information including, age, marital status, education, income, and job. Furthermore, information on smoking cigarettes including number of smoking per day, duration of smoking, cigarettes brand, nicotine concentration, and history of cessation was obtained. RESULTS: Mean ± SD of age and daily cigarette consumption were 39.7 ± 1.1 and 22.1 ± 1.1 respectively. Failure rate of smoking cessation was higher in the lower age group (odds ratios [OR] 2.9; 95% confidence intervals [CI] 1.1, 7.7) and less than 10 numbers smoking per day (OR 2.4; 95% CI 1.3, 4.5) and duration of smoking more than 30 years (OR 3.4; 95% CI 1.2, 9.3) and foreign cigarette brand (OR 1.8; 95% CI 1.1, 2.7). Length time of cessation was prominent in participants with lower age group (OR 5.4; 95% CI 1.3, 22.1), and less than 10 numbers smoking per day (OR 2.7; 95% CI 1.5, 4.9) and lower in smokers with duration of smoking more than 10 and 10-19 years (OR 0.32; 95% CI 0.12, 0.89), (OR 0.34; 95% CI 0.17, 0.76), respectively. CONCLUSIONS: The above results suggest that there are a significant association between socio-demographic factors and smoking-related behaviors in the Iranian population, consistent with previous reports world-wide. These factors should be considered to have appropriate public-health and policy response.