Congenital cytomegalovirus infection in newborns suspected of congenital rubella syndrome in Iran: a cross-sectional study.

BACKGROUND: Following rubella virus control, the most important cause of congenital infections is human cytomegalovirus (HCMV). Congenital CMV (cCMV) may happen both in primary and non-primary maternal infections. The present study aimed to screen cCMV in symptomatic newborns suspected of congenital rubella syndrome (CRS) in Iran. METHODS: Out of 1629 collected infants' serum samples suspected of CRS but negative for rubella IgM, 524 samples were selected regarding cCMV complications. These samples were divided into two age groups: 1- one month and younger, 2- older than 1 month up to one year. Anti-HCMV IgM detection was performed on these serums. Then HCMV IgG avidity assay and HCMV DNA detection were carried out on all samples with positive and borderline results in IgM detection. RESULTS: Herein, 3.67% of symptomatic infants aged one month and younger had positive and borderline HCMV IgM, 12.5% of which had a low avidity index (AI). HCMV IgM detection rate among symptomatic infants older than one month to one year was 14.5%. Identified genotypes in this study were gB-1(63.63%), gB2 (18.18%), and gB3 (18.18%), respectively. CONCLUSIONS: This comprehensive study was performed on serum samples of symptomatic infants clinically suspected of cCMV from all over Iran. There was a good correlation between serology findings and PCR.

Terminal deoxynucleotidyl transferase-mediated formation of protein binding polynucleotides.

Terminal deoxynucleotidyl transferase (TdT) enzyme plays an integral part in the V(D)J recombination, allowing for the huge diversity in expression of immunoglobulins and T-cell receptors within lymphocytes, through their unique ability to incorporate single nucleotides into oligonucleotides without the need of a template. The role played by TdT in lymphocytes precursors found in early vertebrates is not known. In this paper, we demonstrated a new screening method that utilises TdT to form libraries of variable sized (vsDNA) libraries of polynucleotides that displayed binding towards protein targets. The extent of binding and size distribution of each vsDNA library towards their respective protein target can be controlled through the alteration of different reaction conditions such as time of reaction, nucleotide ratio and initiator concentration raising the possibility for the rational design of aptamers prior to screening. The new approach, allows for the screening of aptamers based on size as well as sequence in a single round, which minimises PCR bias. We converted the protein bound sequences to dsDNA using rapid amplification of variable ends assays (RAVE) and sequenced them using next generation sequencing. The resultant aptamers demonstrated low nanomolar binding and high selectivity towards their respective targets.

Evaluation of the Effect of Lavender Aroma on Fatigue Among Hemodialysis Patients.

Fatigue is a complication of hemodialysis (HD). We examined the effect of aromatherapy on fatigue in 62 HD patients. Data were collected using a questionnaire and the Piper Fatigue Scale. It was found that fatigue decreased in the intervention group (P < .05). Lavender aromatherapy is useful in reducing fatigue.

Myocardial perfusion imaging and appropriateness of the test for preoperative cardiac risk evaluation in an Iranian population: clinical role of Duke Activity Status Index.

OBJECTIVE: For preoperative radionuclide myocardial perfusion imaging, metabolic equivalent is one of the key factors to evaluate the appropriateness. Duke Activity Status Index is a practical method to calculate metabolic equivalents. We intended to validate Duke Activity Status Index in our population for the assessment of preoperative myocardial perfusion imaging appropriateness. METHODS: A total of 542 patients referred for myocardial perfusion imaging were recruited. A questionary compiled from Duke Activity Status Index was filled out based on which metabolic equivalents were calculated. Demographic data and history of cardiac risk factors were also collected. Myocardial perfusion imaging was performed using a 2-day stress-rest protocol either by exercise tolerance test or by pharmacologic stress through injection of Tc-MIBI and imaging by a dual-head gamma camera. RESULTS: Out of 542 patients, 369 (68.1%) were evaluated for preoperative risk assessment. Metabolic equivalents (oxygen consumption/min/kg) were calculated at 9.3 ± 5.1, 10.8 ± 4.8, and 8.7 ± 5.1 in total, preoperative patients and patients evaluated for ischemia due to nonsurgical purposes, respectively (p = 0.001). The myocardial perfusion imaging was rarely appropriate in 291 (79.5%), maybe appropriate in 67 (18.3%), and appropriate in 8 (2.2%) patients. The prevalence of abnormal myocardial perfusion imaging was 22.5%, 28.4%, and 12.5% in "rarely appropriate," "maybe appropriate," and "appropriate" scenarios, respectively. Metabolic equivalents were similar between patients with normal and abnormal myocardial perfusion imaging (8.7 ± 5.0 vs. 8.5 ± 5.4). CONCLUSION: Either Duke Activity Status Index is not a proper tool for calculation of metabolic equivalents or the appropriate use criteria is not operational in the population of Iranian preoperative patients in which cultural factors may contribute.

Quality and cost analysis of a wastewater treatment plant using GPS-X and CapdetWorks simulation programs.

Wastewater management is a significant challenge, especially for arid and semiarid countries due to the water scarcity crisis. Considering human health, environmental regulations, wastewater treatment plant expenses, and water reusability, this study aims to assist in designing an efficient and economical WWTP. Technical and economic simulation and modeling are important for designing, constructing, and predicting the requirements of wastewater treatment plant designs. Simulation of a project before its implementation, in the first place, reduces additional costs, and from another point of view, a project is examined and researched from different aspects. In this study, three wastewater treatment plants based on conventional activated sludge, contact stabilization, and step aeration were simulated and evaluated technically and economically using the Zargandeh treatment plant data in Tehran. In three scenarios, GPS-X software investigated the effect of raw wastewater variations between their minimum and maximum intervals on effluent quality, and because the range of inlet effluent was different, more precise results were obtained. Then, the economic costs of the project, including implementation, maintenance, and also energy use, were calculated by Capdetwork software, and contact stabilization was found to be more cost-effective.

The ameliorating effects of anthocyanins on the cross-linked signaling pathways of cancer dysregulated metabolism.

Cancer cells underlie the dysregulated metabolism of carbohydrate, lipid and protein and thereby, employ interconnected cross-linked signaling pathways to supply adequate energy for growth and related biosynthetic procedures. In the present study, a comprehensive review of cancer metabolism and anthocyanin's effect was conducted using the existing electronic databases, including Medline, PubMed, Scopus, and Web of Science, as well as related articles in the field. Such keywords as "cancer", and "cancer metabolism" in the title/abstract/keyword and all the "anthocyanins" in the whole text were used. Data were collected without time restriction until February 2020. The results indicated the involvement of several signaling pathways, including inflammatory PI3K/Akt/mTOR pathway, Bax/Bcl-2/caspases as apoptosis modulators, and NF-κB/Nrf2 as oxidative stress mediators in the cancer dysregulated metabolism. Compelling studies have shown that targeting these pathways, as critical hallmarks of cancer, plays a critical role in combating cancer dysregulated metabolism. The complexity of cancer metabolism signaling pathways, along with toxicity, high costs, and resistance to conventional drugs urge the need to investigate novel multi-target agents. Increasing evidence has introduced plant-derived secondary metabolites as hopeful anticancer candidates which target multiple dysregulated cross-linked pathways of cancer metabolism. Amongst these metabolites, anthocyanins have demonstrated positive anticancer effects by targeting inflammation, oxidative stress, and apoptotic signaling pathways. The current study revealed the cross-linked signaling pathways of cancer metabolism, as well as the promising pharmacological mechanisms of anthocyanins in targeting the aforementioned signaling mediators. To overcome the pharmacokinetic limitations of anthocyanins in cancer treatment, their interactions with gut microbiota and the need to develop related nano-formulations were also considered.

Recent Progress in the Development of Conducting Polymer-Based Nanocomposites for Electrochemical Biosensors Applications: A Mini-Review.

Among various immobilizing materials, conductive polymer-based nanocomposites have been widely applied to fabricate the biosensors, because of their outstanding properties such as excellent electrocatalytic activity, high conductivity, and strong adsorptive ability compared to conventional conductive polymers. Electrochemical biosensors have played a significant role in delivering the diagnostic information and therapy monitoring in a rapid, simple, and low cost portable device. This paper reviews the recent developments in conductive polymer-based nanocomposites and their applications in electrochemical biosensors. The article starts with a general and concise comparison between the properties of conducting polymers and conducting polymer nanocomposites. Next, the current applications of conductive polymer-based nanocomposites of some important conducting polymers such as PANI, PPy, and PEDOT in enzymatic and nonenzymatic electrochemical biosensors are overviewed. This review article covers an 8-year period beginning in 2010.

Rupestrines A-D, alkaloids from the aerial parts of Corydalis rupestris.

Phytochemical investigation of the dichloromethane extract of the dried aerial parts of Corydalis rupestris (Papaveraceae) resulted in the identification of four new isoquinoline alkaloids rupestrines A-D and one known isoquinoline alkaloid, namely, stylopine. The structures of these compounds were characterized by extensive spectroscopic methods including 1D- (1H and 13C) and 2D NMR experiments (COSY, HSQC, HMBC, and NOESY) as well as HRESIMS analyses. In addition, the absolute configurations of rupestrines A-D were determined using modified Mosher's method. Cytotoxic effects of alkaloids and their interaction with albumin were also investigated in this study.

Evaluation of the expression level of 12/15 lipoxygenase and the related inflammatory factors (CCL5, CCL3) in respiratory syncytial virus infection in mice model.

Human respiratory syncytial virus (RSV) is a leading cause of acute respiratory infection during early childhood and imposes a great burden on patients, parents, and society. Disease is thought to be caused, at least partially, by an excessive immune response. Pulmonary leukocyte infiltration is the result of a coordinated expression of diverse chemokines with distinct cellular specificities. Lipoxygenases (LOXs), as a key enzyme catalyzing deoxygenation of poly unsaturated fatty acids, regulate inflammation and have been suggested to play an important role in the immune response in viral infection. To expand our understanding on the possible role of LOX in respiratory viral infection, we studied the 12/15- lipoxygenase expression in RSV-related airway inflammation, and the related inflammatory chemokines, Chemokine (C-C motif) ligand 5 (CCL5) and Chemokine (C-C motif) ligand 3(CC L3) in both lung tissue and Bronchoalveolar lavage (BAL) fluid during experimental RSV infection. RSV infection induced mRNA expression of CCL5 and CCL3 in both BAL and lung tissue cells. In addition RSV infection enhanced expression of 12/15-LOX in both BAL and lung cells. In conclusion, we confirm that RSV infection leads to the increased expression of 12/15 LOX and the related chemokines CCL5 and CCL3 in BAL fluid and lung tissue cells suggesting that the 12/15 LOX pathway could serve as a candidate target for prevention and treatment of RSV infection.

PREDICTION OF RELAPSE FROM HYPERTHYROIDISM FOLLOWING ANTITHYROID MEDICATION WITHDRAWAL USING TECHNETIUM THYROID UPTAKE SCANNING.

OBJECTIVE: Technetium thyroid uptake (TTU) is not inhibited by antithyroid drugs (ATD) and reflects the degree of thyroid stimulation. We intended to predict the relapse rate from hyperthyroidism based on TTU measurement. METHODS: Out of 44 initially enrolled subjects, 38 patients aged 41.6 ± 14.6 with Graves disease (duration: 84 ± 78 months) completed the study. TTU was performed with 40-second imaging of the neck and mediastinum 20 minutes after injection of 1 mCi technetium-99m pertechnetate. TTU was measured as the percentage of the count of activity accumulated in the thyroidal region minus the mediastinal background uptake to the count of 1 mCi technetium-99m under the same acquisition conditions. Then methimazole was stopped and patients were followed. The optimal TTU cutoff value for Graves relapse prediction was calculated using Youden's J statistic. RESULTS: Hyperthyroidism relapsed in 11 (28.9%) patients 122 ± 96 (range: 15-290) days post-ATD withdrawal. The subjects in remission were followed for 209 ± 81 days (range: 88-390). TTU was significantly higher in patients with forthcoming relapse (12.0 ± 8.0 vs. 3.9 ± 2.0, P = .007). The difference was significant after adjustment for age, sex, history of previous relapse, disease duration, and thyroid-stimulating hormone (TSH) levels before withdrawal. The area under the receiver operative characteristic (ROC) curve was 0.87. The optimal TTU cutoff value for classification of subjects with relapse and remission was 8.7 with sensitivity, specificity, and positive and negative predictive value of 73%, 100%, 100%, and 90%, respectively (odds ratio [OR] = 10.0; 95% confidence interval [CI]: 3.4-29.3). CONCLUSION: TTU evaluation in hyperthyroid patients receiving antithyroid medication is an accurate and practical method for predicting relapse after ATD withdrawal. ABBREVIATIONS: ATD = antithyroid drugs RIU = radio-iodine uptake TSH = thyroid-stimulating hormone TSI = thyroid-stimulating immunoglobulin TTU = technetium thyroid uptake.

Use of sedative drugs at reducing the side effects of voiding cystourethrography in children.

BACKGROUND: Imaging of the kidneys and urinary tract has a significant and critical role for diagnosis of genitourinary system diseases. Although technological progress goes toward less invasive approaches, some of the current methods are still invasive and annoying. Voiding cystourethrography (VCUG) is the best and most accurate method for diagnosis and grading of vesicoureteral reflux. VCUG is a distressful procedure that gives serious anxiety and pain in a large proportion of children and fear for parents; therefore, using effective sedative drugs with the least side effects is necessary and should be considered. MATERIALS AND METHODS: In this review article, importance and efficacy of different drugs before catheterization VCUG be compared in the base of literature survey on EMBASE, PubMed, and Cochrane source. RESULTS: We found that the treatment should be based on nonpharmacological and pharmacological methods; nonpharmacological treatment includes the psychological preparation before procedures as a safety precaution with little or no risk modality, as well as reassuring support. The presence of parents during painful procedures cannot alleviate children distress. Pharmacological methods include oral midazolam (0.5 mg/kg) and intranasal use (0.2 mg/kg) that had been used 10 min before the procedure can effect on anterograde amnesia and sedation without considerable effect on accuracy and grade of reflux. Nitric oxide has a shorter recovery time versus midazolam but has a potential risk for deep sedation and may interfere with the child's voiding phase. CONCLUSION: In summary, oral midazolam of 0.5-0.6 mg/kg or 0.2 mg/kg intranasal is acceptable drug that can be used before VCUG.

Seasonal influenza A/H3N2 virus infection and IL-1Β, IL-10, IL-17, and IL-28 polymorphisms in Iranian population.

Increased blood cytokines is the main immunopathological process that were attributed to severe clinical outcomes in cases of influenza A/H3N2 virus infection. The study was aimed to investigate the polymorphisms of IL-1ß, IL-10, IL-17, and IL-28 genes to find the possibility of their association with the clinical outcome of influenza A/H3N2 virus infection among the infected patients in Iran. This is a Case-Control study in which influenza A/H3N2 virus positive confirmed with real-time PCR were the cases. DNA samples from groups were genotyped for polymorphisms in rs16944 (IL-1ß), rs1800872 (IL-10), rs2275913 (IL-17), and rs8099917 (IL-28). Confidence interval (95%CI) and Odds ratio (OR) were calculated. IL-17 rs2275913 (GG and AG) were associated with risk of infection with that were statistically significant (P < 0.05, OR = 2.08-2.94). IL-1ß (rs16944) (GG) was associated with reduced risk of infection (P < 0.01, OR = 0.46). Genotype GG and GT of IL-10 (rs1800872) were associated with increased risk of infection with influenza A/H3N2 virus (P < 0.05, OR = 2.04-2.58). In addition, IL-28 (rs8099917) genotypes GG (P < 0.05, OR = 0.49) and TG (P < 0.05, OR = 0.59) were associated with reduced risk of ILI symptom while genotype TT (P < 0.01, OR = 4.31) was associated with increased risk of ILI symptom. The results of this study demonstrated that polymorphisms of genes involved in the inflammatory and anti-inflammatory process affect the outcome of disease caused by influenza A/H3N2 virus. Thorough insight on host immune response at the time of influenza A virus infection is required to ensure adequate patient care in the case of feature outbreaks. J. Med. Virol. 88:2078-2084, 2016. © 2016 Wiley Periodicals, Inc.

The etiology of Rubella IgM positivity in patients with rubella-like illness in Iran from 2011 to 2013.

Rubella is a mild self-limiting contagious viral disease caused by the rubella virus (RV). Although symptoms are often mild, the concern is centralized around the possible effect on a fetus growth and development in case of primary infection during early months of pregnancy. Recently acquired rubella is commonly confirmed by RV-specific IgM antibody detection in the serum. However, rubella primary infection is not always the only cause of IgM positivity. Other possible causes of rubella IgM positivity may include IgM persistence following vaccination or naturally acquired infection or even re-infection. Moreover, nonspecific IgM reactivity can cause false-positive results. There are few articles to differentiate the aetiology of rash in rubella-like illnesses. However, limited studies have been conducted on clarifying the source of IgM positivity in these cases. This article reports the study of 10,896 clinical cases demonstrating rubella-like illness between 2011 and 2013 in Iran. The rate of IgM positivity among these cases was 0.52% (57 cases). As predicted based on the high coverage of vaccination in Iran fewer than 16% of cases with ELISA IgM positive result, were due to current rubella primary infections. The greater part of the positive IgM reactions occurred in cross reactivity with other viruses (31.6%) or in prolonged IgM response post vaccination (24.6%). This research confirmed that the positive result of rubella IgM assay in vaccinated individuals is mainly caused by prolonged IgM production, rubella re-infection, and false positivity due to infection with other viruses, rather than the rubella primary infection itself.

Epidemiological and clinical evaluation of children with respiratory virus infections.

BACKGROUND: Respiratory viruses are the leading cause of respiratory tract infections among children and are responsible for causing morbidity and mortality worldwide. This study was performed to detect viruses in children with respiratory infections and describe their epidemiology and clinical characteristics. METHODS: In this descriptive cross sectional study, throat swabs and wash specimens from 202 children younger than six years of age with diagnosis of a respiratory tract infection from a total of 897 specimens were evaluated using multiplex PCR method. RESULTS: Respiratory viruses were detected in 92 children: respiratory synsytial virus, 16.8%; influenza virus, 5.4%; parainfluenza virus, 8.4%; adenovirus, 14.4% and human metapneumo virus 0.49% with male predominance and higher distribution in children younger than 1 year of age with preference in the cold months of year. The clinical presentations of all detected viruses were almost similar. CONCLUSION: In the present study, nine different respiratory viruses were detected. RSV causes the great majority of respiratory virus infections in children. There was no significant difference in epidemiologic patterns of these viruses in comparison to other studies.

A case report of massive retrosternal goiter in a 54-year-old woman with symptoms of head and neck swelling and dyspnea.

Anterior mediastinal mass often is serious and its diagnosis requires a comprehensive evaluation involving imaging studies, pathological analysis and consultation with a multidisciplinary team involving radiologist, thoracic surgeons, and oncologist.

Bio-distribution study of Tc-99m HMPAO labeled platelet in healthy volunteer.

Objectives: The bio-distribution of Tc-99m HMPAO labeled platelets (LP), which could be used to image subtle thrombosis, is not reported in a human yet, which is the subject of the current study. Method: The platelets were extracted from 49 ml whole blood and labeled with Tc-99m HMPAO, then re-injected to the healthy volunteer. Anterior and posterior whole body imaging was done by a dual-head gamma camera 3, 18, 33, 46, 81, 124, 190 min and 15 hours after injection. Also a whole-body SPECT was done at 137 min post-injection. The area under the curves of the spleen, liver, left kidney, bladder, right lung, brain, and abdominal aorta ROIs was calculated to estimate the accumulation of labeled platelets within the organs. Results: The spleen was the target organ. The kidneys, liver, and heart were also remarkably visualized. The thyroid, stomach, bladder, or gastrointestinal (GI) uptake/activity was not significant. The stomach visualization was enhanced after ingestion at 60 min. The sagittal and lateral sinuses were delineated, and the background of the brain was very low. During the study, the area under the curve of activity was 738, 308, 302, 196, 230, 121, 79, 216, 529, 369, 162, and 54 counts. min/pixel for spleen, liver, heart, right lung, left kidney, right iliac artery, sagittal sinus, thyroid, bladder, stomach, GI, and background, respectively. Conclusion: The quality of the scan with low dose Tc-99m HMPAO LPs is optimal. We documented the bio-distribution of LPs. The optimal imaging time was 80-120 min post-injection when the free Tc-99m and GI transit were negligible. The sagittal and lateral sinuses were visualized enabling detection of possible clots in the vessels.

Brown-Vialetto-Van Laere syndrome.

Brown-Vialetto-Van Laere syndrome (BVVLS) is a rare neurodegenerative disorder of childhood. According to the previous reports, it has various primary signs and symptoms. Because of the simple treatment with riboflavin supplementation, it is important to have suspicious to this disease and begin treatment even before genetic test confirm. We report a five-year-old girl with BVVLS that manifest with hearing problems, first. There was obvious improvement in her disease clinical signs with riboflavin supplementation treatment.

Rapidly progressing pediatric Lupus with Diffuse Alveolar Hemorrhage and CNS involvement.

Key Clinical Message: Systemic Lupus Erythematosus (SLE) can have an insidious onset and a fatal prognosis in children. Patients presenting without typical signs of SLE should undergo further evaluation if they are not responding to the initial diagnosis and treatment. This is especially true for patients with rapidly progressing symptoms and deterioration in spite of treatment. Abstract: Pediatric Systemic Lupus Erythematosus is a chronic autoimmune disorder with various organ involvement pulmonary involvement in the course of this disorder is a rare yet potentially life-threatening complication. In this case report we highlight the findings of a 16-year-old girl acutely and initially presenting with cough and fever, eventually complicating to diffuse alveolar hemorrhage and gradual loss of consciousness. Although the patient was started on immunosuppressive treatment after the diagnosis of lupus, based on renal and hematological impairment, was made and initially responded, she eventually deteriorated.

Segmentation of liver and liver lesions using deep learning.

Segmentation of organs and lesions could be employed for the express purpose of dosimetry in nuclear medicine, assisted image interpretations, and mass image processing studies. Deep leaning created liver and liver lesion segmentation on clinical 3D MRI data has not been fully addressed in previous experiments. To this end, the required data were collected from 128 patients, including their T1w and T2w MRI images, and ground truth labels of the liver and liver lesions were generated. The collection of 110 T1w-T2w MRI image sets was divided, with 94 designated for training and 16 for validation. Furthermore, 18 more datasets were separately allocated for use as hold-out test datasets. The T1w and T2w MRI images were preprocessed into a two-channel format so that they were used as inputs to the deep learning model based on the Isensee 2017 network. To calculate the final Dice coefficient of the network performance on test datasets, the binary average of T1w and T2w predicted images was used. The deep learning model could segment all 18 test cases, with an average Dice coefficient of 88% for the liver and 53% for the liver tumor. Liver segmentation was carried out with rather a high accuracy; this could be achieved for liver dosimetry during systemic or selective radiation therapies as well as for attenuation correction in PET/MRI scanners. Nevertheless, the delineation of liver lesions was not optimal; therefore, tumor detection was not practical by the proposed method on clinical data.

Comparison of the dried properties of Ganoderma lucidum produced by the convective dryer and infrared dryer.

Ganoderma lucidum is a promising medicine with a high amount of antioxidants and calcium. The selection of appropriate drying process methods in food science has a chief role to reach the best final characteristics. This study aimed to investigate the effects of air velocity and temperature in the convective dryer, sample distance, and infrared power in infrared dryers on the drying kinetics and quality of Ganoderma lucidum slices. In addition, Response Surface Methodology based on central composition design was used to optimize and analyze drying conditions. The ranges of temperature and air velocity were 40-60 °C and 0.5-1.5 m/s, respectively in the convective drying process while the range of distance and infrared power was 4-16 cm and 500-1500 W, respectively in the infrared drying process. It is worth mentioning that antioxidant and calcium contents were greatly enhanced during the drying procedures. Moreover, the values of the total color difference ranged between 8.21 and 19.66 for the convective dryer and 8.14 and 28.85 for the infrared dryer. A kinetic study indicated that dried samples by the infrared dryer could rapidly reach equilibrium moisture content due to exposure to IR radiation. Consequently, the results indicated that the infrared dryer has better performance than the convective dryer regarding drying time, energy consumption, and amount of calcium and antioxidant.