The role of inflammatory mediators in the pathogenesis of periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) syndrome.

INTRODUCTION: As a recurrent disease, periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome is characterized by episodes of febrile attacks and is often prominent in children under five years of age. However, the etiology of this condition has not been fully understood yet. MATERIALS AND METHODS: The search in the extensive literature of peer-reviewed articles published from the inception to December 2021 was conducted to identify the relevant studies, using the electronic databases of MEDLINE/PubMed, Embase, Scopus, the Cochrane Library, and the Web of Science. RESULTS: The analysis of complex relationships indicates that inflammatory factors, such as various cytokines and acute-phase proteins (APPs), play leading roles in the pathogenesis of this disease. Accordingly, this article summarizes the current state of knowledge to explain the mechanisms involved in inflammatory responses among patients with PFAPA syndrome and investigate its role in the pathogenesis of this disease. Moreover, the possibilities for further implementation of new therapeutic strategies are pointed out. CONCLUSION: It is concluded that some pathophysiological processes are associated with immune dysregulation, which itself may be secondary to environmental factors, genetic background, and underlying diseases, including latent infections that multiply inflammatory mediators. elevated inflammatory markers similarly play a significant part in the clinical outcomes of this condition, whose pyrogenic nature is the reason for the development of episodes of febrile attacks in the population of patients suffering from PFAPA syndrome.

Maternal sciatic nerve administered bupivacaine induces hippocampal cell apoptosis in offspring.

BACKGROUND: Bupivacaine, an amid-type local anesthetic, is widely used for clinical patients especially in pregnant women. In addition to neurotoxicity effect of bupivacaine, it can cross the placenta, accumulates in this tissue and retained in fetal tissues. Nevertheless, whether bupivacaine can cause neurotoxicity in fetus remains unclear. Hence, this study was design to investigate the effects of maternal bupivacaine use on fetus hippocampal cell apoptosis and the possible related mechanism. METHODS: On day 15 of pregnancy, sciatic nerve of pregnant wistar rat (180-200 g) were exposed by lateral incision of the right thigh and 0.2 ml of bupivacaine was injected. After their delivery, we randomly selected one male offspring of every mother. On day 30 after of their birth, the rat's hippocampi were isolated for molecular studies. Western blotting was used to examine the expression of cleaved caspase-3, caspase-8 and p-Akt in fetal hippocampus. RESULTS: Our results showed that maternal bupivacaine use caused a significant increment of cleaved caspase-3 and caspase-8 expression in fetal hippocampus compared with the sham group. In addition, maternally administered bupivacaine could significantly decrease hippocampal P.Akt/T.Akt ratio which was concurrent with an increment of cleaved caspase-3 and caspase-8 expression. CONCLUSION: Our data suggest that maternal bupivacaine use increases fetal hippocampal cell apoptosis markers such as caspase 8 and cleaved caspase 3, at least in part, via inhibiting the Akt activation.

Prevalence of Hepatitis B Virus Markers among the Women with Breast Cancer.

INTRODUCTION: Breast cancer represents a formidable peril to the female populace on a worldwide level. The association between breast cancer and various factors, including viral infections, has been extensively investigated. Recently, the link between HBV infection and breast cancer patients has garnered attention. The present research aims to assess the prevalence of HBV markers among women diagnosed with breast cancer in Ahvaz city, Iran. MATERIALS AND METHODS: Serum specimens were procured from 90 patients who had been clinically diagnosed with breast cancer. The age of the patients ranged from 29 to 80 years, with a mean age of 49.42±10.7. Histological examination of biopsy specimens revealed that 75 (83.33%) were ductal, 11 (8.88%) lobular, 2 (2.22%) mucinous, 1 (1.11%) medullary, and 1 (1.11%) was metastatic. The serum samples were subjected to initial HBsAg and anti-HBc testing via ELISA. Samples that tested seropositive (HBsAg + anti-HBc) were subsequently analyzed for the S region of HBV through nested PCR and DNA sequencing. Finally, a phylogenetic tree was constructed for positive HBV DNA tests. RESULTS: Among the 5/90 (5.55%) cancer patients, it was found that 3 (3.33%) cases of ductal carcinoma and one (1.11%) lobular carcinoma displayed positivity for HBV markers (HBsAg, anti-HBc, HBV PCR). Notably, one (1.11%) patient with ductal carcinoma solely demonstrated anti-HBc positivity. The phylogenetic tree analysis of the S region revealed that all HBV strains identified were categorized as genotype D. CONCLUSION: The statistical analysis did not reveal any significant findings (p= 0.315) in the distribution of cancer types across different age groups. Among patients diagnosed with breast cancer, a notable prevalence of 5.5% was observed in HBV markers. The dominant HBV genotype among breast cancer patients was identified as genotype D.

Impact of COVID-19 acute respiratory disease on the risk factors attributed to cancer patients.

Communicable diseases (CDs) based on Health organization reported are one of the most threat for human health. SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) is the main pandemic that nowadays it threatens the health of people around the world, especially cancer patients. The purpose of this study was to investigate the effects of COVID-19 acute respiratory disease (COVID-19 ARD) on risk factors related to health of cancer patients. A review study of was conducted to base on results of various studies published. Nine hundred and eighty articles were retrieved based on various databases: Science Direct, Taylor & Francis, Google Scholar, Elsevier, PubMed and BMJ. In this study, were used the results of research on COVID-19 and its effects on risk factors attributed to cancer patients. The literature signs a notable undesirable affect from COVID-19 on risk factors attributed to health of cancer patients. Result showed that transfer SARS-CoV-2 viruses can endanger health of cancer patients due to interruption of the disease treatment process and increase number of deaths between in this patents. The survey requires the need to act creating healthy conditions to continue the treatment process and vaccination coverage among these patients in order to decrease the transmission of COVID-19 acute respiratory disease and increase the success rate of cancer treatment.

Carcinogenic Risk Assessment among Children and Adult due to Exposure to Toxic Air Pollutants.

Health endpoint and risk of carcinogenic among people enhancement due to Exposures to toxic air pollutants. The purpose of this study was investigation of a carcinogenic risk assessment among children and adults due to exposure to toxic pollutants. A review study of literature was performed with seven hundred and twenty-six articles were retrieved based on Google Scholar, Web of Science, PubMed, Elsevier, and Springer databases. Studies reporting data on predetermined consequences potential toxic air pollutants and related to lifetime cancer risk (LCR) and hazard quotient (HQ) were used to assess carcinogenic and non-carcinogenic risk. The literature signs a notable undesirable affect from potential toxic air pollutants related to carcinogenic risk assessment among children and adult. Based on Result this study, the toxic air pollutants can endanger health of children and adult exposure to this pollutant and increase lifetime cancer risk number and carcinogenic risk among exposed people. Useful for health policymaker in order to cope with the incidence of cancer among citizenship Can be the main application the results of this study. Increasing the level of public awareness, especially of sensitive groups, about the incidence of cancer and its important factors and reduce exposures to toxic air pollutants are the main vital government actions for decrease the prevalence of cancer. Further research using more sophisticated methodology is warranted.

Association between gastrointestinal symptoms and disease severity in patients with COVID-19 in Tehran City, Iran.

Introduction: It is important to identify the relationship between COVID-19 and gastrointestinal symptoms for health organizations in different communities. Aim: To assess the relationship between gastrointestinal symptoms and COVID-19. Material and methods: It was a cross-sectional descriptive-analytical study that was conducted on 381 patients those where admitted to Imam Hossein Hospital with a confirmed diagnosis of COVID-19 on nasopharyngeal polymerase chain reaction testing for SARS-CoV-2 from first March to end of June in Tehran city; 2020. Data was entered and analyzed by using SPSS version 22 and level of significant was consider less than 0.05. Results: Out of all the patients with COVID-19, 164 (43%) had gastrointestinal symptoms. The most symptoms of them were nausea (19.2%), vomiting (17.2%), abdominal pain (15.7%), diarrhoea (12.6%), haematomas (1%), melena (1.6%), rectal bleeding (1.6%), and constipation (1.8%), respectively. The mean D-dimer1 value was significantly different between the 2 groups with gastrointestinal symptoms and no gastrointestinal symptoms. In other words, there is a strong relationship between the variable D-dimer1, which is one of the important symptoms showing the severity of COVID-19 disease, and gastrointestinal symptoms (p < 0.0001). Conclusions: Our finding shows a statistical relationship between the level of D-dimer and gastrointestinal symptoms in patients with COVID-19. The mortality rate was higher in patients with gastrointestinal symptoms, which is an important outcome for gastroenterologists.

Long non-coding RNA signatures and related signaling pathway in T-cell acute lymphoblastic leukemia.

T-cell acute lymphoblastic leukemia (T-ALL) is a malignancy caused by clonal proliferation of T-cell pre-cursors arising from the thymus. Although the optimized chemotherapy regimen could improve the outcome of such patients, some challenges such as higher risk for induction failure, early relapse and isolated central nervous system (CNS) relapse occurring in T-ALL patients are of great significance, leading to increased mortality rates. Long non-coding RNA (lncRNA) is a key component involved in cell signaling through a variety of mechanisms in regulating gene expression. Oncogenes and tumor suppressors are no exception and their expression can be affected by lncRNAs. In addition, accumulating researches in samples from T-ALL patients as well as pre-clinical studies in mice suggest that the expression profile of lncRNAs in T-ALL could be aberrant, resulting in deregulation of target genes and downstream signaling pathways. In addition, accumulating researches in samples from T-ALL patients as well as pre-clinical studies in mice suggest that the expression profile of lncRNAs in T-ALL could be aberrant, resulting in deregulation of target genes and downstream signaling pathways. These lncRNAs may be determinants of proliferation, apoptosis, and drug resistance observed in T-ALL. Thus, lncRNAs can be a good tool to develop novel strategies against cancer cells in the treatment of relapsed and refractory T-ALL. They can also act as promoting biomarkers in assessing T-ALL and differentiating between patients with poor prognosis and good prognosis.

Irritable Bowel Syndrome Demographics: A Middle Eastern Multinational Cross-sectional Study.

BACKGROUND: Irritable bowel syndrome (IBS) is the most frequent functional gastrointestinal (GI) disorder. In this study, we aimed to evaluate the different aspects of IBS among Middle Eastern residents. METHODS: During the study period, patients attending gastroenterology clinics of nine tertiary referral centers in four Middle Eastern couturiers (Iran, Egypt, Kuwait, and Turkey) were evaluated by Rome IV diagnostic criteria, and those who fulfilled the diagnostic criteria of IBS were asked to fill in a questionnaire covering different demographics and clinical aspects. RESULTS: Overall, during a 6-month period, 509 patients with IBS were included. 41.3% of the participants were male (210 patients), and 37.4% of them had academic education. 50% of the participants were Caucasian, and 34% were Arab, and originally, they were citizens of 18 countries. 77.4% of the participants were residents of subtropical areas, while 22.2% were living in temperate regions. The average age of the participants during the first presentation in subtropical and temperate areas were 38.4 ± 12.19 and 38.06 ± 12.18 years, respectively (P = 0.726). The most common subtypes of IBS in subtropical areas were unclassified (IBS-U, 44.4%), constipation dominant (IBS-C, 27.6%), mixed pattern (IBS-M, 21%), and diarrhea dominant (IBS-D, 6.8%) in descending order while in temperate areas the most common subtypes were IBS-U (43.3%), and IBS-D (22.1%), respectively (P < 0.001). Besides abdominal pain, the most common symptom of patients in each region was bloating (62.2% and 68.1%, respectively, P = 0.246). The rate of depression and anxiety were significantly higher among the residents of temperate areas in comparison with subtropical regions (41.6% vs. 16.5% and 80.5% vs. 58.4%, respectively, P < 0.001). CONCLUSION: Although the average age of IBS presentation is the same in subtropical and temperate areas, it seems that in temperate areas, the rate of IBS-D is more prevalent than in subtropical regions. The rate of anxiety and depression are significantly higher among those who searched social media and the internet to get information about their problems.

Introducing GATA3 as a prominent player in Crohn's disease.

AIM: This study was aimed at gene assessment of Crohn's disease (CD) through protein-protein interaction (PPI) network analysis to find crucial genes. BACKGROUND: CD is a major subtype of inflammatory bowel diseases (IBD), which affects gastrointestinal tract. PPI network analysis is a suitable tool to clarify a critical gene as a drug target or diagnostic biomarker for these types of diseases. METHODS: Gene expression profile GSE126124 of 20 CD patients and 20 healthy controls was obtained from the Gene Expression Omnibus (GEO) database. RNA profile of peripheral blood mononuclear cells (PBMCs) and colon biopsy samples of the studied groups was investigated. Crucial genes were selected and analyzed via the PPI network by Cytoscape software. Gene ontology enrichment for the hubs, bottlenecks, and hub-bottlenecks was performed via CluGO plugin of Cytoscape software. RESULTS: Eighty-one differentially expressed genes (DEGs) among 250 initial DEGs were highlighted as significant by FC>2 and p-value ≤ 0.05, and 69 significant DEGs were used for PPI network construction. The network was characterized by poor connections, so 20 top neighbors were added to form a scale-free network. The main connected component included 39 query DEGs and 20 added first neighbors. Three clusters of biological processes associated with crucial genes were identified and discussed. CONCLUSION: The results of this study indicated that GATA3 has a key role in CD pathogenesis and could be a possible drug target or diagnostic biomarker for Crohn's disease.

The effects of IL-8, IL- 6, and IL-1 on the risk of celiac disease: a Bayesian regression analysis.

AIM: The present study aimed to evaluate the association between serum levels of interleukin IL-1, IL-6, IL-8 genes as well as interferon (IFN)-γ and the risk of celiac disease (CD). BACKGROUND: The role of serum cytokine levels in the pathophysiology of CD is still an open field to be explored. METHODS: This case-control study was performed on 110 patients with CD and 46 healthy controls referring to Taleghani Hospital, Tehran, Iran. Expression levels of IL-1, IL-6, IL-8, and IFN-γ were assessed by enzyme-linked immunosorbent assay (ELISA) kits. RESULTS: The Bayesian intervention odds ratio (OR) and Highest Posterior Density (HPD) interval were 1.133 (95% credible interval 1.018- 1.269), 0.947 (95% credible interval 0.898 - 0.996) and 1.004 (95% credible interval 1.001- 1.009) for IL-1, IL-6, and IL-8 respectively. CONCLUSION: The serum level of IFN-γ has no effect on the risk of CD, but given the OR and the HPD interval obtained for serum levels of IL-1, IL-6 and IL-8, with one unit increase in IL-1 serum, the risk of CD grows by 1.13 times while one unit increase in IL-6 serum reduces the risk of CD by 15%. Finally, regarding IL-8, the risk of CD increases by 0.004 times with a unit increase in IL-8 serum.

Metabolic analysis of acute appendicitis by using system biology approach.

AIM: Introducing possible suitable compound as diagnostic agent in appendicitis is aim of this investigation. BACKGROUND: Appendicitis diagnosis is a difficult step in treatment of disease due to complex abdominal pain signal which may be refer to the non-appendicitis pain. METHODS: Gene expression profiles of children with non-preforated appendicitis in comparison with the samples with non- appendicitis abdominal pain are analysis via protein - protein interaction (PPI) and the critical compounds are introduced by STITCH. RESULTS: Ten compounds including including MgATP, glycerol, MgADP, calcium ions, chloride, magnesium, phosphate, sulphate, acetate, and sodium are introduced as possible biomarker panel to differentiate appendicitis from the other abdominal pains. CONCLUSION: A laboratory method such as flame photometry based on metal detection for diagnosis of appendicitis is possible, however more investigations are required.

Cocoon Peritonitis Secondary to Perforated Appendicitis.

A young man was admitted due to gastrointestinal obstruction and was diagnosed as having cocoon peritonitis secondary to perforated appendicitis. He suffered from small intestine partial obstruction because of multiple adhesion bands whose obstructive symptoms completely resolved after single balloon enteroscopy. So balloon enteroscopy could be offered as a therapeutic option for partial small intestine obstruction.

Long non-coding RNA signatures and related signaling pathway in T-cell acute lymphoblastic leukemia

T-cell acute lymphoblastic leukemia (T-ALL) is a malignancy caused by clonal proliferation of T-cell pre-cursors arising from the thymus. Although the optimized chemotherapy regimen could improve the outcome of such patients, some challenges such as higher risk for induction failure, early relapse and isolated central nervous system (CNS) relapse occurring in T-ALL patients are of great significance, leading to increased mortality rates. Long non-coding RNA (lncRNA) is a key component involved in cell signaling through a variety of mechanisms in regulating gene expression. Oncogenes and tumor suppressors are no exception and their expression can be affected by lncRNAs. In addition, accumulating researches in samples from T-ALL patients as well as pre-clinical studies in mice suggest that the expression profile of lncRNAs in T-ALL could be aberrant, resulting in deregulation of target genes and downstream signaling pathways. In addition, accumulating researches in samples from T-ALL patients as well as pre-clinical studies in mice suggest that the expression profile of lncRNAs in T-ALL could be aberrant, resulting in deregulation of target genes and downstream signaling pathways. These lncRNAs may be determinants of proliferation, apoptosis, and drug resistance observed in T-ALL. Thus, lncRNAs can be a good tool to develop novel strategies against cancer cells in the treatment of relapsed and refractory T-ALL. They can also act as promoting biomarkers in assessing T-ALL and differentiating between patients with poor prognosis and good prognosis. (AU)

The effect of pentoxifylline on reduction of proteinuria among patients with type 2 diabetes under blockade of angiotensin system: a double blind and randomized clinical trial.

Although blockade of renin-angiotensin system have been cited as the first line of therapy for the management of diabetic nephropathy (DN), however in a substantial number of patients, progression of renal disease are not completely halted by these agents. We have conducted a double blinded clinical trial to assess the additive effect of pentoxifylline on reduction of proteinuria among patients with type 2 DM under blockade of angiotensin system. The dosage of PTX used in our trial was at a low dosage of 400mg daily and to our knowledge, we did not found article which evaluated the antiproteinuric effect of pentoxifylline in this dosage. One hundred patients with DN and persistent proteinuria despite treatment with losartan and enalapril in at least 3 months before inclusion in the study were randomly assigned to two groups. Control group (n=50, 26 males and 24 females) received losartan and enalapril, while treatment group (PTX Group) (n=50, 28 males and 22 females) was given losartan, enalapril and pentoxifylline 400mg/day for 6 months. At the beginning of the study there were no significant differences in demographic and clinical characteristics of patients including serum creatinine, HbA1c, blood pressure and urinary protein excretion between two groups (P>.05). In the PTX group, the mean rate of urinary protein excretion have significantly decreased from 616.66mg to 378.24 after 3 months (P=.000) and to 192.05mg after 6 months (P=.000) whereas no significant changes were observed in the control group. The beneficial antiproteinuric effect of PTX was not associated to the degree of metabolic control and a reduction of blood pressure. In addition, at the end of study, the mean clearance of creatinine was significantly higher in PTX group (P=.04). In conclusion, PTX can significantly provide additive antiproteinuric effect and slow the decrease in GFR among patients with type 2 DM under blockade of angiotensin system.

The effect of pentoxifylline on reduction of proteinuria among patients with type 2 diabetes under blockade of angiotensin system: a double blind and randomized clinical trial

Although blockade of renin-angiotensin system have been cited as the first line of therapy for the management of diabetic nephropathy (DN), however in a substantial number of patients, progression of renal disease are not completely halted by these agents. We have conducted a double blinded clinical trial to assess the additive effect of pentoxifylline on reduction of proteinuria among patients with type 2 DM under blockade of angiotensin system. The dosage of PTX used in our trial was at a low dosage of 400mg daily and to our knowledge, we did not found article which evaluated the antiproteinuric effect of pentoxifylline in this dosage. One hundred patients with DN and persistent proteinuria despite treatment with losartan and enalapril in at least 3 months before inclusion in the study were randomly assigned to two groups. Control group (n=50, 26 males and 24 females) received losartan and enalapril, while treatment group (PTX Group) (n=50, 28 males and 22 females) was given losartan, enalapril and pentoxifylline 400mg/day for 6 months. At the beginning of the study there were no significant differences in demographic and clinical characteristics of patients including serum creatinine, HbA1c, blood pressure and urinary protein excretion between two groups (P>.05). In the PTX group, the mean rate of (..) (AU)

Aunque el bloqueo del sistema renina-angiotensina ha sido citado como el tratamiento inicial para la nefropatía diabética (ND), en un número significativo de pacientes el avance de la enfermedad renal no se ve frenado en su totalidad por estos agentes. Hemos realizado un ensayo clínico doble ciego para valorar el efecto acumulativo de la pentoxifilina (PTX) en la reducción de la proteinuria en pacientes con diabetes tipo 2 (DM2) con bloqueo del sistema de angiotensina. La dosis de PTX utilizada en nuestro ensayo fue una cantidad baja de 400 mg diarios y, en nuestra experiencia, no logramos encontrar ningún artículo que evaluara el efecto antiproteinúrico de la PTX con esta dosis. De forma aleatoria, se dividieron en dos grupos 100 pacientes con ND y proteinuria persistente a pesar del tratamiento con losartán y enalapril durante al menos tres meses antes de ser incluidos en el estudio. El grupo de control (n = 50, 26 hombres y 24 mujeres) fueron tratados con losartán y enalapril, mientras que el grupo de tratamiento (grupo de PTX: n = 50, 28 hombres y 22 mujeres) recibieron losartán, enalapril y 400 mg/día de pentoxifilina durante 6 meses. Al comienzo del estudio no se encontraron diferencias significativas en las (..) (AU)