Association between exposure to water sources contaminated with polycyclic aromatic hydrocarbons and cancer risk: A systematic review.

The recent scientific focus on polycyclic aromatic hydrocarbons (PAHs) has stemmed from their recognized genotoxic, mutagenic, and carcinogenic properties. This systematic review seeks to evaluate the nexus between exposure to water sources contaminated with PAHs and the associated cancer risk among global populations, encompassing both children and adults. Web of Science (WoS), Cochrane Library, PubMed, ProQuest, Scopus, and Google Scholar, were searched following the PRISMA guidelines, until December 31, 2023. Quality assessment of the selected studies was performed using the Newcastle-Ottawa Scale. The increased lifetime cancer risk (ILCR) attributed to PAH exposure through ingestion and dermal absorption was thoroughly examined across diverse age groups. After extensive searching, screening, and eligibility, 30 articles were included in this review, which was conducted in different parts of the world, including Nigeria (n = 11), China (n = 7), India (n = 4), Iran (n = 3), South Africa (n = 2), Italy (n = 1), Colombia (n = 1), and Iraq (n = 1). Our analysis underscores Nigeria's alarming prevalence of PAH contamination in its rivers, groundwaters, and seawater. Remarkably, the highest cancer risk was identified among children and adults, notably in proximity to the Atlas Cove jetty (seawater) and various Nigerian rivers. This elevated risk is primarily attributed to the combined effects of ingestion and dermal absorption. Furthermore, our findings emphasize the prominent role of combustion-derived and pyrogenic sources of PAH in the examined aquatic ecosystems. This study unequivocally establishes that PAH-contaminated water sources significantly amplify the risk of cancer among both children and adults. The extent of risk variation is influenced by the specific water source, duration of exposure, and age group. Consequently, proactive identification of contaminated water sources and their pollution origins, coupled with targeted educational campaigns, holds promise for reducing the global burden of PAH-related cancer.

Congenital simple hamartoma of the retinal pigment epithelium: 4 cases with multimodal imaging.

BACKGROUND: Congenital simple hamartoma of the retinal pigment epithelium is often identified as an incidental finding. One important issue is the differentiation of these benign lesions from other lesions which could be potentially sight-threatening. METHODS: This study describes 4 cases of congenital simple hamartoma of the retinal pigment epithelium that were referred to a university-based hospital. Multimodal imaging including fundus photo, multicolor fundus photo, fundus autofluorescence, optical coherence tomography (OCT), OCT angiography, fluorescein angiography and multifocal electroretinogram is provided. RESULTS: The first case is a young man with an incidental finding of this lesion. The second and third cases are diabetic patients with congenital simple hamartoma of the retinal pigment epithelium and diabetic macular edema and the fourth one is a case of congenital simple hamartoma of the retinal pigment epithelium with a full-thickness macular hole. CONCLUSIONS: Differentiation of congenital simple hamartoma of the retinal pigment epithelium from other potentially sight-threatening lesions is important. Multimodal imaging can be helpful regarding this issue. Besides typical findings described in the literature, unique features in our cases include concurrent diabetic macular edema and association with a full-thickness macular hole.

Dietary Diabetes Risk Reduction Score (DDRRS) and Breast Cancer Risk: A Case-Control Study in Iran.

INTRODUCTION: Given the role of type 2 diabetes and insulin resistance in tumor initiation, we hypothesized that following a diet that reduces the risk of type 2 diabetes could also reduce the risk of breast cancer. Herein, we conducted a case-control study to investigate the association between dietary diabetes risk reduction score and breast cancer risk in Iranian women. METHOD: We recruited 136 newly diagnosed cases and 272 age-matched hospitalized controls from referral hospitals. A valid and reliable 168-item food frequency questionnaire (FFQ) was used to collect the data on dietary intake. We used Multivariate Logistic regression to assess the odds ratio (OR) with 95% confidence interval (CI) of breast cancer by the dietary diabetes risk reduction score tertiles. RESULTS: After adjusting for confounding variables, no association was seen between dietary diabetes risk reduction score and breast cancer risk (OR = 0.65, 95% CI: 0.37-1.14). However, after stratification by menopausal status, a decreased risk was observed between adherence to dietary diabetes risk reduction score and breast cancer risk in postmenopausal individuals (OR = 0.43, 95% CI: 0.19-0.99). CONCLUSION: The present study states that there is no significant relationship between the dietary diabetes risk reduction score and the risk of breast cancer. However, adherence to dietary diabetes risk reduction score could have a preventive role for breast cancer among postmenopausal women.

Impact of first eye cataract surgery on falls among patients of advanced age: a comparative study.

OBJECTIVE: To compare the incidence of falls between patients with visually significant cataracts in both eyes and those who have undergone first-eye cataract surgery. METHODS: This retrospective case-control study involved patients with a history of cataracts in both eyes who had undergone first-eye cataract surgery within the past 9 to 12 months (pseudophakic group). The control group comprised patients with cataracts in both eyes (cataract group). We assessed best-corrected visual acuity (BCVA), systemic comorbidities and medications (using the Charlson comorbidity index), and independent daily activities (using the Lawton Instrumental Activities of Daily Living scale). The patients were questioned about experiencing two or more falls in the last 6 months. RESULTS: Each group comprised 50 patients. Binocular BCVA was significantly better in the pseudophakic group (0.05 ± 0.06 logMAR) than in the cataract group (0.77 ± 0.34 logMAR). Of all participants, 22% reported experiencing two or more falls in the last 6 months. Multivariate analysis demonstrated significantly better BCVA in participants with less than two falls. CONCLUSIONS: Patients of advanced age with visually significant cataracts in both eyes are at a higher risk of falling. First-eye cataract surgery may mitigate the occurrence of falls by improving binocular BCVA.

Phycocyanin as a nature-inspired antidiabetic agent: A systematic review.

BACKGROUND: Nutraceuticals have been important for more than two decades for their safety, efficacy, and outstanding effects. Diabetes is a major metabolic syndrome, which may be improved using nutritional pharmaceuticals. Some microalgae species, such as spirulina, stand out by providing biomass with exceptional nutritional properties. Spirulina has a wide range of pharmacological effects, mostly related to phycocyanin. Phycocyanin is a protein compound with antidiabetic properties, known as a nutraceutical. OBJECTIVE: This review delves into phycocyanin applications in diabetes and its complications and ascertains the mechanisms involved. METHODS: Scopus, PubMed, Cochrane Library, Web of Science, and ProQuest databases were systematically reviewed (up to April 30, 2023), in which only animal and cellular studies were found. RESULTS: According to animal studies, the administration of phycocyanin affected biochemical parameters (primary outcome) related to diabetes. These results showed an increase in fasting insulin serum and a decrease in fasting blood glucose, glycosylated serum protein, and glycosylated hemoglobin. In cellular studies, though, phycocyanin prevented methylglyoxal and human islet amyloid polypeptide-induced dysfunction in ß-cells and induced apoptosis through different molecular pathways (secondary outcome), including activation of Nrf2, PI3K/Akt, and suppression of JNK and p38. Also, phycocyanin exerted its antidiabetic effect by affecting the pathways regulating hepatic glucose metabolism. CONCLUSIONS: Thus, based on the available information and literature, targeting these pathways by phycocyanin may unleash an array of benefits, including positive outcomes of the antidiabetic effects of phycocyanin as a nutraceutical. OTHER: This systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) at the National Institute of Health. The registration number is CRD42022307522.

Dietary iron and the risk of lung cancer.

Animal models have suggested the carcinogenic effect of iron due to its oxidative potential. The lung is particularly vulnerable to oxidative stress. However, epidemiological studies investigating the association between dietary iron and the risk of lung cancer have reported inconclusive results. In this systematic review and meta-analysis, we aimed to clarify this association. Methods: We searched PubMed, Web of Science, Scopus and Google scholar for eligible articles published through May 2023 reporting the Relative Risk (RR), Hazard Ratio (HR) or Odds Ratio (OR) with 95% confidence interval (95% CI). Case-control and cohort studies that examined the relationship between dietary iron and lung cancer risk were included and review and meta-analyses articles, experimental studies, abstracts, letters to editor and studies with insufficient data were excluded. Finally, three case-control studies and 6 cohort studies were included. Random effect models were used to calculate the pooled results. Results: Nine studies (cases n=21,943, participants n=1,542,993) were included. There were no significant associations between the highest dietary total iron (heme and non-heme) (RR: 1.09, 95% CI: 0.78 to 1.51) or heme iron (RR: 1.01, 95% CI: 0.73 to 1.38) intake compared to the lowest intake with lung cancer risk. Null-associations were also observed in the subgroup analysis based on smoking status and lung cancer histology. However, in the subgroup of women (cases n=5074), heme iron was associated with a 14% increase in the risk of lung cancer (RR: 1.14, 95% CI: 1.01 to 1.29). Conclusions: The current results demonstrated that there is no significant relationship between dietary iron intake and the risk of lung cancer. However, a positive association was observed between dietary heme iron and the risk of lung cancer in women, which may require further investigation.

Electromagnetic fields exposure on fetal and childhood abnormalities: Systematic review and meta-analysis.

Today, in the modern world, people are often exposed to electromagnetic waves, which can have undesirable effects on cell components that lead to differentiation and abnormalities in cell proliferation, deoxyribonucleic acid (DNA) damage, chromosomal abnormalities, cancers, and birth defects. This study aimed to investigate the effect of electromagnetic waves on fetal and childhood abnormalities. PubMed, Scopus, Web of Science, ProQuest, Cochrane Library, and Google Scholar were searched on 1 January 2023. The Cochran's Q-test and I 2 statistics were applied to assess heterogeneity, a random-effects model was used to estimate the pooled odds ratio (OR), standardized mean difference (SMD), and mean difference for different outcomes, and a meta-regression method was utilized to investigate the factors affecting heterogeneity between studies. A total of 14 studies were included in the analysis, and the outcomes investigated were: change in gene expression, oxidant parameters, antioxidant parameters, and DNA damage parameters in the umbilical cord blood of the fetus and fetal developmental disorders, cancers, and childhood development disorders. Totally, the events of fetal and childhood abnormalities were more common in parents who have been exposed to EMFs compared to those who have not (SMD and 95% confidence interval [CI], 0.25 [0.15-0.35]; I 2, 91%). Moreover, fetal developmental disorders (OR, 1.34; CI, 1.17-1.52; I 2, 0%); cancer (OR, 1.14; CI, 1.05-1.23; I 2, 60.1%); childhood development disorders (OR, 2.10; CI, 1.00-3.21; I 2, 0%); changes in gene expression (mean difference [MD], 1.02; CI, 0.67-1.37; I 2, 93%); oxidant parameters (MD, 0.94; CI, 0.70-1.18; I 2, 61.3%); and DNA damage parameters (MD, 1.01; CI, 0.17-1.86; I 2, 91.6%) in parents who have been exposed to EMFs were more than those in parents who have not. According to meta-regression, publication year has a significant effect on heterogeneity (coefficient: 0.033; 0.009-0.057). Maternal exposure to electromagnetic fields, especially in the first trimester of pregnancy, due to the high level of stem cells and their high sensitivity to this radiation, the biochemical parameters of the umbilical cord blood examined was shown increased oxidative stress reactions, changes in protein gene expression, DNA damage, and increased embryonic abnormalities. In addition, parental exposure to ionizing and non-ionizing radiation can lead to the enhancement of different cell-based cancers and developmental disorders such as speech problems in childhood.

Pediatric rhegmatogenous retinal detachment: A meta-analysis of clinical features, surgical success rate, and prognostic factors.

Pediatric rhegmatogenous retinal detachment (RRD) is an issue of debate regarding its surgical outcomes and prognosis because of diagnosis delay, more complex etiological factors, and a higher prevalence of postoperative complications. This meta-analysis aims to evaluate the anatomical and visual outcomes of pediatric RRD and the factors that influence the treatment results. This is the first meta-analysis on this subject. We searched the relevant publications in the electronic databases of PubMed, Scopus, and Google Scholar. Eligible studies were included in the analysis. Anatomical success after one surgery and the final rates of success were estimated. Subgroup analysis was performed to find the rate of success in patients with different prognostic factors. This meta-analysis showed that the total rate of success after one surgery was about 64%, which implies that performing the first surgery was enough to get anatomical reattachment in most of the patients. The final anatomical rate of success was about 84%. In terms of visual acuity, the pooled results revealed statistically significant (P < 0.001) improvement in postoperative vision, with a 0.42 reduction in log of minimum angle of resolution (logMAR). The final rate of success was significantly lower in eyes with proliferative vitreoretinopathy (PVR) (about 25% lower in eyes with PVR, P < 0.001) and in the presence of congenital anomalies (about 36% lower in congenital cases, P = 0.008). Myopic RRD had a significantly better anatomical success rate. In conclusion, this study shows that there is a high chance of anatomical success after pediatric RRD treatment. The presence of PVR and congenital anomalies was associated with a poorer prognosis.

Cystoid macular oedema without leakage in fluorescein angiography: a literature review.

Cystoid macular oedema (CMO), which is defined as a macular thickening and cystic changes due to accumulation of fluid, could be asymptomatic and only diagnosed using paraclinical techniques. Fluorescein angiography (FA) and optical coherence tomography (OCT) are useful in detecting CMO in clinical practice. Non-leaking CMO, also known as angiographically silent CMO, is referred to as cases of CMO without leakage in fluorescein angiography. This type of CMO has been reported in some retinal dystrophies, in cases of maculopathy as a side effect of certain drugs, and also in some systemic disorders. The exact mechanism and treatment options for this type of CMO are still not clear. This literature review aims to discuss different causes of non-leaking CMO, proposed mechanisms, and management options. Three sections including drugs, retinal dystrophies, and systemic disorders are discussed in this review.

Clinical outcomes of off-pump coronary artery bypass graft in patients with diabetes and non-diabetics: A systematic review and meta-analysis.

BACKGROUND AND AIM: Diabetes mellitus is a prevalent risk factor for developing coronary artery disease which worsens the clinical outcomes of patients undergoing coronary artery bypass grafting (CABG). This study aimed to determine the clinical outcomes of patients with diabetes and non-diabetic patients who underwent off-pump CABG surgery. METHOD: Medline, Scopus, Proquest, Embase, Web of Science, and Google scholar were searched until September 10, 2021. The effect sizes including unstandardized mean difference and odds ratio with 95% confidence interval were calculated using "Metan" package. The Cochran's Q-test and I2 statistic were used to assess heterogeneity, a random-effects model was applied to estimate the pooled effect sizes, and meta-regression was used to investigate the factors affecting heterogeneity between studies. RESULTS: 10 studies with 6200 sample sizes were included in the study. In groups with diabetes, Summary odds ratio (SOR) and 95% confidence interval of infection was 2.18 more than non-diabetic groups. Also, odds renal complication was 1.74 more than non-diabetic groups, and the odds cardiovascular complication in groups with diabetes was 1.30 more than non-diabetics. There were no differences in mortality, neurologic, respiratory and surgical complications between groups with diabetes and non-diabetics. Based on meta-regression results, age (Coefficient: 0.942; p = 0.009) had a significant direct relationship and sample size (Coefficient: 0.001; p = 0.009) had an indirect significant relationship with heterogeneity of neurologic outcomes. There was no significant publication bias in our results. CONCLUSION: Our study revealed that off-pump CABG led to some significant outcomes in patients with diabetes compared to non-diabetics. Renal and infection complications were higher in patients with diabetes but no significant differences were seen in most of other postoperative outcomes between the two groups.

Is non-high-density lipoprotein associated with metabolic syndrome? A systematic review and meta-analysis.

Introduction: Novel atherogenic lipid indices, including non-high-density lipoprotein cholesterol (non-HDL-C) which is calculated by subtracting the HDL-C value from the total cholesterol level, atherogenic index (ratio between triglycerides (TG) and HDL-C concentrations (TG/HDL-C)), and Diff-C (calculated by subtracting low-density lipoprotein (LDL-C) from non-HDL-C), have been known as valuable predictors of dyslipidemia and subsequent cardiovascular diseases. Previous studies have reported the potential association of novel atherogenic lipid indices with metabolic syndrome (MetS). This meta-analysis aimed to assess the pooled association of novel atherogenic lipid indices with MetS or its components. Methods: A systematic search was conducted through PubMed, Scopus, and Web of Science (WoS) databases from January 2000 until March 2021 to evaluate the association of novel atherogenic lipid indices, including non-HDL-C, atherogenic index, and the difference between non-HDL-C and LDL-C (Diff-C) with MetS. Observational studies were included without any language restriction. As exclusive studies evaluating the association of non-HDL-C with metabolic syndrome (MetS) were eligible to be included in quantitative analyses, a random-effect meta-analysis was performed to pool the odds ratios (ORs). A stratified meta-analysis was performed based on the definition of MetS [Adult Treatment Panel (ATP) and International Diabetes Federation (IDF)] and the studied population. Results: Overall, 318 studies were retrieved from an initial systematic search. After screening, 18 and five studies were included in the qualitative and quantitative syntheses, respectively. Qualitative synthesis revealed an association between non-HDL-C, Diff-C, and atherogenic index with MetS and its components. Stratified meta-analysis showed that an increased non-HDL-C level was associated with an increased odds of MetS based on ATP criteria (OR: 3.77, 95% CI: 2.14-5.39) and IDF criteria (OR: 2.71, 95% CI: 1.98-3.44) in adults (OR: 3.53, 95% CI: 2.29-4.78) and in children (OR: 2.27, 95% CI: 1.65-2.90). Conclusion: Novel atherogenic lipid indices, including atherogenic index, Diff-c, and non-HDL-C, are strongly associated with increased odds of MetS and its components. The indices could be considered as potential predictors of MetS and its components in clinical practice.

Retinotomy and Retinectomy in the Management of Rhegmatogenous Retinal Detachment Associated with Advanced Proliferative Vitreoretinopathy.

Purpose: To report the anatomical and functional outcomes of retinotomy and/or retinectomy for the management of rhegmatogenous retinal detachment (RRD) complicated by advanced proliferative vitreoretinopathy (PVR). Methods: In this retrospective study, the charts of patients who underwent pars plana vitrectomy with retinotomy and/or retinectomy for the management of RRD complicated by PVR were reviewed. Primary outcome measures were final best-corrected visual acuity (BCVA) and anatomical reattachment rate. Results: Sixty-one eyes of 61 patients with a mean age of 48.56 ± 15.92 were studied. The mean follow-up time was 21.38 ± 23.08 months. The mean angle of the retinotomy was 171.31° ± 79.15°. Thirty-two (52.5%) of them needed extensive (≥180°) retinotomy. In addition, simultaneous retinectomy was performed in 36.2% of the cases. The BCVA was 2.18 ± 0.63 and 1.85 ± 0.71 logMAR before the surgery and at the last visit, respectively (P = 0.001). The initial anatomical success was achieved in 45 eyes (73.8%) after retinotomy surgery. Sixteen eyes (26.2%) had recurrent RD and needed reoperation, which was performed 5.60 ± 4.01 months after the initial retinotomy surgery. At the last examination, the retina was attached in all patients. Conclusion: Retinotomy with/without retinectomy is an effective procedure in the majority of patients with RRD associated with advanced PVR; however, additional surgeries are needed in a significant number of eyes to achieve final anatomical success.

Intravitreal recombinant tPA before vitrectomy for diabetic tractional retinal detachment: A randomized controlled trial.

PURPOSE: To investigate the effect of intravitreal recombinant tissue plasminogen activator (rt-PA) injection before vitrectomy on surgical facility and outcome in diabetic tractional retinal detachments (TRD). METHODS: Prospective, randomized, interventional clinical trial. A total of 38 eyes with diabetic TRD were candidates for vitrectomy. Patients were randomized 1:1 to receive intravitreal rt-PA, five to seven days before vitrectomy or no injection. Intraoperative surgical facility and anatomic success at month 3 after surgery were assessed. RESULTS: Mean patient age was 54.2 ± 9.4 years. There was no statistically significant difference between rt-PA and no injection groups with regard to anatomic success (89% versus 95%, respectively, P = 0.547) and best corrected visual acuity at 3 months (2.0 versus 2.1 logMAR, respectively, P = 0.840). However, surgical facility score was statistically significantly lower in rt-PA injection group compared to no injection group (4.1 ± 1.7, 5.8 ± 2.0, respectively, P = 0.007). CONCLUSIONS: Vitrectomy for TRD was easier after preoperative rt-PA injection, without affecting the anatomic and visual outcomes.

The Effect of Aromatherapy Alone or in Combination with Massage on Dysmenorrhea: A Systematic Review and Meta-analysis / O efeito da aromaterapia sozinha ou em combinação com massagem na dismenorreia: Uma revisão sistemática e meta-análise

Abstract Objective The aim of the present systematic review meta-analysis is to assess the effect of olfactory stimulation on reducing dysmenorrhea. Methods Systematic search was conducted in several databases, such as PubMed, Web of Science, Cochrane, and Scopus, to identify relevant research up to October 26, 2019. The identified studies were evaluated based on a modified Jadad scale. The intervention involves aromatherapy alone or in combination with essential oils. There was no restriction for the control group such as a placebo group or other common treatments. The Comprehensive Meta-Analysis Version 2 (Bio stat, Englewood, NJ, USA) was used for meta-analysis. Cochran's Q and I2 tests were utilized. Results The findings of our meta-analysis, which contained 13 trials (15 data), showed that dysmenorrhea decreased significantly in the group receiving aromatherapy with herbal compared with the control group (standardized mean difference [SMD] =-0.795; 95% confidence interval [CI]: -0.922 to- 0.667; 17 trials O < 0.001); heterogeneity; I2 = 19.47%; p = 0.236). In addition, four studies with insufficient data were not included in our meta-analysis. The results of all studies suggested that aromatherapy with herbal medicine group compared with control group is effective. Conclusion Aromatherapy with herbal medicine decreased dysmenorrhea. This treatment was particularly effective when aroma oil was combined with massage or when a mixture of aroma oil was used for the treatment of dysmenorrhea.

Resumo Objetivo O objetivo desta revisão sistemática-metanálise é avaliar o efeito da estimulação olfatória na redução da dismenorreia. Métodos Pesquisa sistemática foi realizada em várias bases de dados, como PubMed, Web of Science, Cochrane e Scopus para identificar pesquisas relevantes até 26 de outubro de 2019. Os estudos identificados foram avaliados com base em uma escala de Jadadmodificada. A intervenção envolvearomaterapiasozinhaouem combinação com óleos essenciais. Não houve restrição para o grupo de controle, como um grupo de placebo ou outros tratamentos comuns. O Comprehensive Meta-Analysis Version 2 (Bio stat, Englewood, NJ, EUA) foi usado para meta-análise. Os testes Q e I2 de Cochran foram utilizados. Resultados Os resultados da nossa meta-análise, que continha 13 ensaios (15 dados), mostraram que a dismenorreia diminuiu significativamente no grupo que recebeu aromaterapia com ervas em comparação com o grupo de controle (diferença média padronizada [DMP] = -0,795; intervalo de confiança [IC] de 95%: -0,922 a- 0,667; 17 ensaios O <0,001); heterogeneidade; I2 = 19,47%; p = 0,236). Além disso, quatro estudos com dados insuficientes não foram incluídos em nossa meta-análise. Os resultados de todos os estudos sugeriram que a aromaterapia com o grupo de fitoterápicos em comparação com o grupo de controle é eficaz. Conclusão A aromaterapia com fitoterapia diminuiu a dismenorreia. Este tratamento foi particularmente eficaz quando o óleo aromático foi combinado com massagem ou quando uma mistura de óleo aromático foi usada para o tratamento da dismenorreia.

Intravitreal Methotrexate.

Intravitreal methotrexate (MTX) has been proven to be an effective treatment for various intraocular diseases. In this article, a comprehensive review was performed on intravitreal applications of methotrexate. Different aspects of the administration of intravitreal MTX for various clinical conditions such as intraocular tumors, proliferative vitreoretinopathy, diabetic retinopathy, age-related macular degeneration, and uveitis were reviewed and the adverse effects of intravitreal injection of MTX were discussed. The most common indications are intraocular lymphoma and uveitis. Other applications remain challenging and more studies are needed to establish the role of intravitreal MTX in the management of ocular diseases.

Can Prenatal and Postnatal Cell Phone Exposure Increase Adverse Maternal, Infant and Child Outcomes? / A exposição pré-natal e pós-natal a telefones celulares pode aumentar os resultados adversos para mães, bebês e crianças?

Abstract Objective To determine the association between maternal mobile phone use and adverse outcomes in infants, children, and mothers. Method In March 202, we conducted a search on the MEDLINE, Embase, and Scopus databases. Data extraction and an assessment of the quality of the studies were performed by two authors. The quality of the studies was assessed using the checklist of the Newcastle-Ottawa scale. Results Studies assessing behavioral problems in infants aged 6 to 18 months reported null findings. However, an increased risk of emotional and behavioral disorders was observed in children aged between 7 and 11 years whose mothers had been exposed to cell phones. The findings regarding the association between maternal cell phone exposure and adverse outcomes in children aged 3 to 5 are controversial. A study found a significant association between the call time (p=0.002) or the history of mobile phone use (in months) and speech disorders in the children (p=0.003). However, another study found that maternal cell phone use during pregnancy was not significantly associated with child psychomotor and mental developments. Inconclusive results were observed about the adverse outcomes in fetuses, such as fetal growth restriction or t scores for birth weight in cell phone users as opposed to non-users. On the contrary, the children ofmothers who were cell phone users had a lower risk of scoring low on motor skills. Similar results were observed regarding the adverse outcomes of cell phone use in infants, such as fetal growth restriction or low birth weight, and the risk of preeclampsia was lower among subjects with medium and high cell phone exposure, as opposed to those with low exposure. Conclusion Studies on behavioral problems have reported different postnatal results, such as null findings among infants and a positive association in children.

Resumo Objetivo Determinar a associação entre o uso de telefone celular pela mãe e os resultados adversos em recém-nascidos crianças e mães. Método Em março de 2020 realizou-se uma pesquisa nas bases de dados MEDLINE, Embase e Scopus. A extração de dados e avaliação da qualidade dos estudos foram realizadas por dois autores. A qualidade dos estudos foi avaliada por meio da lista de verificação da escala Newcastle-Ottawa. Resultados Estudos que avaliavam problemas comportamentais em recém-nascidos de 6 a 18 meses relataram resultados nulos. No entanto um risco aumentado de transtornos emocionais e comportamentais foi observado em crianças de 7 a 11 anos de idade cujas mães foram expostas a telefones celulares. Os resultados relacionados à associação entre a exposição materna a celulares e resultados adversos em crianças de 3 a 5 anos são controversos. Um estudo encontrou associação significativa entre o tempo de ligação (p=0.002) ou o histórico de uso de celular (emmeses) e distúrbios de fala nas crianças (p=0.003). No entanto outro estudo descobriu que o uso de telefone celular pela mãe durante a gravidez não estava significativamente associado ao desenvolvimento psicomotor e mental da criança. Resultados inconclusivos foram observados com relação aos resultados adversos de fetos como restrição de crescimento intrauterino ou valores de t para peso ao nascer em usuárias de telefone celular em oposição a não usuárias. Pelo contrário os filhos de mães usuárias de telefone celular apresentaram menor risco de pontuação baixa em habilidades motoras. Resultados semelhantes foram observados com relação a resultados adversos em recém-nascidos como restrição de crescimento intrauterino ou valores de peso ao nascere o risco de pré-eclâmpsia foimenor em indivíduos comexposição média e alta a celulares em oposição àqueles com baixa exposição. Conclusão Estudos sobre problemas comportamentais relataram resultados diferentes no pós-natal como achados nulos em recém-nascidos e associação positiva emcrianças.

Optic pit-like maculopathy in a patient without any detectable disc anomalies.

Macular schisis is the splitting of the inner retinal layers at macula, with or without associated detachment. The acquired form of macular schisis is frequently associated with optic disc pit maculopathy, although it could be accompanied by several conditions such as tractional maculopathies, cystoid macular edema, veno-occlusive disease, and shaken baby syndrome. However, a small number of cases of retinoschisis without optic disc pit have been reported elsewhere. Here, we present a patient with acquired macular schisis without high myopia and optic disc abnormality in funduscopic examination and imaging. Macular optical coherence tomography of her left eye revealed schisis of the inner and outer retinal layers and subretinal fluid and choroidal thickness of 426 µm (pachychoroid). Although the optic disc of this patient appeared normal, the probable presumption is that small junctions existed between the macular neuroretinal tissue and the vitreous cavity. Further studies are required to survey the other probable mechanisms of retinoschisis without optic pit with more subjects.

Emerging circulating MiRNAs and LncRNAs in upper gastrointestinal cancers.

INTRODUCTION: Circulating non-coding RNAs (ncRNAs) possess high stability in circulation, making them capable of being utilized in the diagnosis, prognosis, and treatment of upper gastrointestinal (GI) tract cancers. AREAS COVERED: Herein, the potential clinical application of emerging circulating miRNAs and lncRNAs in upper GI cancers are comprehensively reviewed. EXPERT OPINION: For esophageal cancer (EC), the circulating miRNAs, miR-21, miR-223, and miR-375 have been validated as promising diagnostic biomarkers in a meta-analysis. For gastric cancer (GC), miR-17, miR-18a, miR-21, miR-25, miR-223, miR-451, and lncRNA-H19 have been reported in several studies and are likely to be promising biomarkers. Unlike EC, many circulating lncRNAs have been newly reported for GC and each is often limited to one study. They show excellent or outstanding discrimination performance, such as XIST, LOC100506474, UCA1, LINC00467, ZNFX1-AS1, HULC, AA174084, CEBPA-AS1, MIAT, PCSK2-2:1, HOTTIP, H19 (AUCs 0.8 to 0.9), and particularly CUDR, LSINCT-5, PTENP1, HOTAIR, and LncRNA-GC1 (AUCs > 0.9). Most importantly, using a group of ncRNAs as a diagnostic panel would give a more promising diagnostic or prognostic performance. However, different clinical trials and large, multi-center cohorts as well as comprehensive meta-analyses should also be conducted to validate and use emerging circulating ncRNAs as the indicators of GI cancers.

Ophthalmic manifestations of congenital protein C deficiency: a case report and mini review.

BACKGROUND: Homozygous protein C (PC) deficiency is a potentially fatal disease with ocular blinding presentation or sequela. CASE PRESENTATION: A 5 month-old boy was presented for evaluation of leukocoria. He had a history of frequent bruises and PC deficiency, treated with warfarin. His intraocular pressure was normal. In the left eye leukoma with anterior segment dysgenesis, shallow anterior chamber, and cataract were observed. Fundus was not visible. B-scan revealed a closed funnel retinal detachment. His right eye had a normal anterior segment and a thin retina with anomalous retinal vascular branching at equator and peripheral retina. A fibrovascular tuft on the optic nerve head with induced traction on superior arcade was visible. Total loss of a and b wave of both were appreciated in electroretinography (ERG). Fluorescein angiography (FA) showed very severe leakage at the junction of the vascularized and non-vascularized retina and optic nerve head. Favorable outcome was achieved with lasering of avascular retina in the right eye. CONCLUSION: The potential for protein C deficiency should be assessed in all infants with leukocoria, anterior segment dysgenesis, retinal detachment and retinal dysplasia. Early diagnosis could save the child's life and vision.