COVID-19-Associated Acute Necrotizing Encephalopathy: A Case Report.

COVID-19 is a pandemic disease in which most patients have pulmonary symptoms. However, several cases of CNS involvement associated with COVID-19 have been reported. Acute necrotizing encephalopathy of childhood (ANEC) is a rare CNS complication of viral infections such as influenza, herpes virus, and COVID-19, leading to high mortality and morbidity rates. Several cases of COVID-19-associated acute necrotizing encephalopathy (ANE) have been reported since March 2020 in adults, with just a few cases in pediatrics. This article reports a 5-month-old child who presented with seizures, with the final diagnosis of ANE as a complication of COVID-19. MRI findings of ANEC, as reported in most COVID-19-associated ANEC case reports, involve bilateral, symmetric, multifocal lesions in the central thalami. Moreover, the brainstem, cerebral white matter, and cerebellum could be affected. The prognosis of COVID-19-associated ANE is poor, leading to neurologic dysfunction or mortality. COVID-19-associated ANE cases must be reported, especially in pediatrics, with detailed clinical history, laboratory data, and radiologic findings to introduce diagnostic criteria, prognosis, and a management protocol.

Biological functions and molecular interactions of Wnt/ß-catenin in breast cancer: Revisiting signaling networks.

Changes in lifestyle such as physical activity and eating habits have been one of the main reasons for development of various diseases in modern world, especially cancer. However, role of genetic factors in initiation of cancer cannot be ignored and Wnt/ß-catenin signaling is such factor that can affect tumor progression. Breast tumor is the most malignant tumor in females and it causes high mortality and morbidity around the world. The survival and prognosis of patients are not still desirable, although there have been advances in introducing new kinds of therapies and diagnosis. The present review provides an update of Wnt/ß-catenin function in breast cancer malignancy. The upregulation of Wnt is commonly observed during progression of breast tumor and confirms that tumor cells are dependent on this pathway Wnt/ß-catenin induction prevents apoptosis that is of importance for mediating drug resistance. Furthermore, Wnt/ß-catenin signaling induces DNA damage repair in ameliorating radio-resistance. Wnt/ß-catenin enhances proliferation and metastasis of breast tumor. Wnt/ß-catenin induces EMT and elevates MMP expression. Furthermore, Wnt/ß-catenin participates in tumor microenvironment remodeling and due to its tumor-promoting factor, drugs for its suppression have been developed. Different kinds of upstream mediators Wnt/ß-catenin signaling in breast cancer have been recognized that their targeting is a therapeutic approach. Finally, Wnt/ß-catenin can be considered as a biomarker in clinical trials.

Non-coding RNAs targeting notch signaling pathway in cancer: From proliferation to cancer therapy resistance.

Cancer is a challenging to treat disease with a high mortality rate worldwide, nevertheless advances in science has led to a decrease in the number of death cases caused by cancer. Aberrant expression of genes occurs during tumorigenesis therefore targeting the signaling pathways that regulate these genes' expression is of importance in cancer therapy. Notch is one of the signaling pathways having interactions with other vital cell signaling molecules responsible for cellular functions such as proliferation, apoptosis, invasion, metastasis, epithelial-to-mesenchymal transition (EMT), angiogenesis, and immune evasion. Furthermore, the Notch pathway is involved in response to chemo- and radiotherapy. Thus, targeting the Notch signaling pathway in cancer therapy can be beneficial for overcoming the therapeutic gaps. Non-coding RNAs (ncRNAs) are a class of RNAs that include short ncRNAs (such as micro RNAs) and long ncRNAs (lncRNAs). MicroRNAs (miRNAs) are ~22 nucleotides in length while lncRNAs have more than 200 nucleotides. Both miRNAs and lncRNAs control vital cellular mechanisms in cells and affect various signaling pathways and Notch is among them. The current review aims to discuss the critical role of ncRNAs in the regulation of the Notch signaling pathway by focusing on different cancer hallmarks including proliferation, apoptosis, autophagy, EMT, invasion, metastasis, and resistance to therapies.

Quality of life in patients with bipolar I disorder: is it related to disorder outcome?

Bipolar I disorder (BID) and its treatments have shown to be associated with deep impacts on patients' subjective feelings and quality of life (QOL). There are also some comments about impact of these feelings on course and outcome of patients with BID. This study was aimed to evaluate quality of life in patients with BID and to assess its relationship with course of disorder. Fifty patients with BID were recruited based on the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) from May 2008 and followed for 12 months. Quality of life and mood disorder recurrence were assessed through World Health Organization Quality of Life and SCID-I tools respectively at baseline and after 6 and 12 months. Repeated measures analysis and logistic regression were used to analyze the independent effect of QOL and demographic factors on BID recurrence. Fifty patients (66% male; 48% never married; 48% in primary school level) with mean ± SE age and age of BID onset 33.8±1.5 and 26.6±1.1 years were studied. They had 3.4±0.6 episodes already. Twenty eight percent suffered from recurrences during the follow-up. The QOL scores at baseline, after 6 and 12 months were 70±1.8, 69.6±1.1 and 73±1.3 respectively. There were no significant change in QOL and its sub-domains during the follow-up (P=0.37). QOL showed no independent relationship with BID recurrences (P>0.1). No change in the QOL during the follow-up could denote lack of effectiveness of routine interventions on this factor. Also, short-term follow-up might be concerned as the possible reason. Of prime importance is to consider quality of life independently in treating patients with bipolar disorder.

Suicide Risk Factors in Iranian Patients With Bipolar Disorder: A 21- Month Follow-Up From BDPF Study.

OBJECTIVE: Bipolar disorder is strongly associated with suicidal ideations, attempts and commissions. Although several studies have been conducted on suicide risk factors in patients with bipolar disorder worldwide, a comprehensive study has not been reported from Iran. METHODS: Patients with bipolar disorder type I, hospitalized in Iran Hospital of Psychiatry since May 2008 to August 2011 were sequentially enrolled. Patients were evaluated using Demographic and Clinical Variables Questionnaire, the Structured Clinical Interview for DSM-IV axis I disorders (SCID-I), Young-Mania Rating Scale (Y-MRS), and Hamilton Depressive Rating Scale-7 (HDRS-7). One hundred patients were followed for 2 to 42 months (mean: 20.6 ± 12.5 months). RESULTS: Only one patient attempted suicide during the follow-up period. 33% of the patients had history of previous suicide attempts. Female gender, divorce, and early age at onset of the disease were independently correlated with suicide attempt. CONCLUSION: Suicide attempts rarely occur during systematic follow-up of patients with bipolar disorder type I. Larger samples and longer follow-ups are needed to confirm this finding. DECLARATION OF INTEREST: None.