Bioelectrocatalytic Activity of One-Dimensional Porous Pt Nanoribbons for Efficient Inhibition of Tumor Growth and Metastasis.

Designing and synthesizing one-dimensional porous Pt nanocrystals with unique optical, electrocatalytic, and theranostic properties are gaining lots of attention, especially to overcome the challenges of tumor recurrence and resistance to platinum-based chemotherapy. Herein, we represented an interesting report of a one-step and facile strategy for synthesizing multifunctional one-dimensional (1D) porous Pt nanoribbons (PtNRBs) with highly efficient therapeutic effects on cancer cells based on inherent electrocatalytic activity. The critical point in the formation of luminescent porous PtNRBs was the use of human hemoglobin (Hb) as a shape-regulating, stabilizing, and reducing agent with facet-specific domains on which fluorescent platinum nanoclusters at first are aggregated by aggregation-induced emission phenomena (AIE) and then crystallized into contact and penetration twins, as intermediate products, followed by shaping of the final luminescent porous ribbon nanomaterials, owing to oriented attachment association via the Ostwald ripening mechanism. From a medical point of view, the key strategy for effective cancer therapy occured via using low-dosage ethanol in the presence of electroactive porous PtNRBs based on intracellular ethanol oxidation-mediated reactive oxygen species (ROS) generation. The role of heme groups of Hb, as electrocatalytically active centers, was successfully demonstrated in both kinetically controlled anisotropic growth of NRBs for slowing down the reduction of Pt(II) followed by oligomerization of Pt(II)-Hb complexes via platinophilic interactions as well as electrocatalytic ethanol oxidation for therapy. Interestingly, hyaluronic acid-targeted (HA) Hb-PtNRB in the presence of low-dose ethanol caused extraordinary arrest of tumor growth and metastasis with no recurrence even after the treatment course stopped, which caused elongation of tumor-bearing mice survival. HA/Hb-PtNRB was completely biocompatible and exhibited high tumor-targeting efficacy for fluorescent imaging of breast tumors. Therefore, the synergistic electrocatalytic activity of PtNRBs is presented as an efficient and safe cancer theranostic method for the first time.

The role of 18F-fluorodeoxyglucose PET/computed tomography in the diagnosis and monitoring of large vessel vasculitides - a review article.

In the last two decades, advancements in positron emission tomography (PET) technology have increased the diagnostic accuracy of patients with large-vessel vasculitis (LVV). Numerous systematic reviews and meta-analyses have been conducted, and patients suspected of having LVV can be diagnosed earlier with 18F-FDG PET. Two subtypes, giant cell arteritis (GCA) and Takayasu arteritis (TA), will progress when their response to corticosteroids and enhanced immunosuppression is inadequate. In the majority of patients, disease activity cannot be monitored solely through laboratory procedures; consequently, glucose metabolism may be a source of potential biomarkers. In this article, we discuss the current state of 18F-FDG PET/CT imaging standards.

Agenesis of the right external iliac artery in a 23-year-old woman with left leg ischemia.

External iliac agenesis is an uncommon congenital issue characterized by the absence or incomplete development of the external iliac artery, a significant blood vessel supplying the lower limbs, potentially causing symptoms like pain, weakness, ischemia, and numbness. We are currently discussing a case of a 23-year-old woman who complained of pain in her left lower limb. A thorough work-up was conducted to rule out ischemia, and during the diagnostic process, a CT scan revealed the complete absence of the right external iliac artery. It can be concluded that this is a rare vascular anomaly that can lead to significant morbidity and mortality. Early diagnosis and prompt management are crucial for preventing complications such as limb ischemia and gangrene.

The diagnostic value of the computed tomography scan and ultrasonography in acute appendicitis.

The most prevalent cause of emergency abdominal surgery is acute appendicitis. Ultrasonography is safe and widely available, although it's operator-dependent and difficult for people with massive bodies. Computed tomography (CT) scans are more accurate than ultrasonography, with a 93 to 98% accuracy rate. The goal of this investigation is to evaluate the diagnostic value of ultrasonography and CT scanning for acute appendicitis. This is a cross-sectional study that was performed on 231 patients with suspected with acute appendicitis. The Alvarado score was initially used to diagnose acute appendicitis. A radiologist performed abdominal ultrasonography on all patients. If the results of the ultrasonography were negative or unclear, a CT scan was performed using oral contrast. Finally, all ultrasonography and CT scan data were reevaluated by an experienced radiologist and compared to the patient's final diagnosis in the case of surgery and pathology results. Comparisons between the two groups were performed. The sensitivity, specificity, and positive and negative predictive value of ultrasonography according to pathology results in patients with low clinical suspicion were 74.9%, 63.4%, 94.3%, and 67.6%, respectively. The sensitivity, specificity, positive and negative predictive value of CT scans based on pathology results were 87.9%, 81.8%, 94.7%, and 79.3%, respectively, in patients with low clinical suspicion. The CT scan results in female patients suspected of appendicitis were completely consistent with the pathology results. The CT scan demonstrated greater specificity and sensitivity in diagnosing acute appendicitis compared to abdominal ultrasonography.

Association between patellofemoral osteoarthritis with demographic features and anatomical variants of the knee in non-traumatic patients.

BACKGROUND: Patellofemoral osteoarthritis (PFOA) is a common cause of knee discomfort and impairment, particularly among athletes. The development of PFOA has been associated with anatomical knee variations, such as trochlear dysplasia and patella alta. However, the relationship between these anatomical variants and the development of PFOA remains poorly understood. This study aimed to investigate the association between PFOA and knee anatomical variants in a cohort of patients. METHODS: The study included 200 patients with PFOA and 200 healthy controls. In this study, we investigate the relationship of osteoarthritis with both anatomical variants and demographic characteristics. The participants underwent Magnetic resonance imaging (MRI) evaluation of the knee, and anatomical variants including trochlear dysplasia and patella alta were assessed. The severity of PFOA was also graded based on cartilage area and depth, as well as the bone marrow involvement and presence of osteophytes. RESULTS: Statistically significant differences were observed between the two groups in terms of Tibial tuberosity-trochlear groove (TT-TG) distance, patella position, trochlear dysplasia, and Insall-Salvati ratio. The mean TT-TG distance, prevalence of alta patella position, and Insall-Salvati ratio were significantly higher in cases (P<0.001 for all), and cases had a higher incidence of trochlear dysplasia (P<0.001). There were no significant differences between cases and controls regarding patella baja. CONCLUSION: Anatomical knee variants, including the TT-TG distance, trochlear dysplasia, and Insall-Salvati ratio, are significant risk factors for PFOA progression. The results also indicate that higher BMI and older age are significantly associated with more measures of MRI Osteoarthritis Knee Score (MOAKS) than demographic information. Among anatomical variants, a higher TT-TG distance and an increased grade of trochlear dysplasia show a significant relationship with more measures of MOAKS. Understanding the relationship between these factors has important clinical and research implications and can help inform the development of new treatments.

Open surgery versus percutaneous nephrolithotomy for management of staghorn calculi.

BACKGROUND: For urologists, treating staghorn stones remains a difficult challenge. Various studies have evaluated the results of percutaneous nephrolithotomy (PCNL) and open surgery in different populations but these results were controversial. Here, we aimed to compare and evaluate the results of open surgery and PCNL in the treatment of staghorn stones. METHODS: This retrospective descriptive study was performed to compare the results of open surgery and PCNL in the treatment of staghorn stones in 2013-2021. A total of 360 participants were studied among the population. Demographic data of patients including age, gender, and comorbidities were obtained. We assessed variables including type of stone, serum creatinine, degree of hydronephrosis, and urine culture before the operation. All participants in our study were informed of the two surgical alternatives. RESULTS: The mean length of hospital stay in PCNL patients was 3.88 ± 1.76 and in open surgery patients was 5.858 ± 2.12 (P = 0.003). In 30 patients (13.9%) in the PCNL group and 27 patients (18.8%) in the open surgery group, bleeding necessitating blood transfusion was the only intraoperative complication. 309 patients (85%) had no residual stones at the time of discharge from the hospital, which was 81.9% (177 cases) in patients treated with PCNL and 91.6% (132 patients) in the open surgery group (P > 0.05). CONCLUSION: Staghorn calculi can be managed effectively with open surgery or PCNL. Given the reduced postoperative complication rate and higher stone-free rate, we believe open surgery is better technique for complicated staghorn stones with a high burden.

Immunoglobulin transmission to infants born to mothers with COVID-19.

BACKGROUND: COVID-19 infection is a severe condition in pregnant women. Previous studies have suggested that anti-COVID-19 antibodies may be able to be transmitted from mother to fetus, which in itself is a protective factor in infants against the disease. However, few studies have been done in this area. In the present study, we aimed to investigate the presence of anti-COVID-19 antibodies in infants born to symptomatic and asymptomatic mothers with positive COVID-19 test. METHODS: This is a cross-sectional study performed in 2021 in Abadan on neonates, born to symptomatic and asymptomatic mothers with positive COVID-19 test. All pregnant women over the age of 38 weeks with positive PCR tests for COVID-19 were included. We collected five cc of blood from the umbilical cord of neonates immediately after birth. The samples were sent to the laboratory in laboratory tubes to measure the anti-COVID-19 IgM and IgG levels. RESULTS: We evaluated data of 20 neonates born to mothers with symptomatic COVID-19 and 10 neonates born to asymptomatic mothers with positive COVID-19 tests. In symptomatic groups, sixteen neonates (80%) had positive IgG antibodies and the mothers of all these neonates had positive antibodies. The mean IgG levels in infants was 73.26 ± 12.54 RU/ml and the mean IgM levels were 14.29 ± 3.71 RU/ml. Among neonates born to mothers with no symptoms, 7 neonates (70%) had positive IgG antibody. All mothers had positive antibodies. The mean IgG levels in infants were 74.50 ± 11.37 RU/ml and the mean IgM levels was 12.49 ± 2.88 RU/ml. There were no significant differences between two groups of neonates regarding positivity of IgG and antibody levels (P>0.05 for all). CONCLUSION: 80% of infants born to mothers with COVID-19 pneumonia had positive IgG levels that were in line with the previous reports.

Evaluation of postoperative bracing on unstable traumatic lumbar fractures after pedicle screw fixation.

BACKGROUND: Fractures of the thoracolumbar and lumbar regions are very important. There is still debate on the use of braces after surgical operations. The current study aims to evaluate and report the outcomes of postoperative bracing following pedicle screw fixation in patients with thoracolumbar and lumbar fractures in Iran. METHODS: This is a clinical trial performed from 2012 to 2022 on 144 patients diagnosed with lumbar and thoracolumbar fractures. Demographic data of patients including age and gender were obtained. Patients' fractures were classified as Frankel (A to E) in terms of clinical and neurological manifestations. Patient's quality of life (QOL) was measured using the 36-Item Short Form Survey (SF-36). All patients underwent surgical fixation of the fracture. Patients were then randomized into two groups using Random Allocation Software. The first group received post-operation bracing and the second group did not receive braces. Thus, radiographic and clinical evaluation data of 1, 3, and 12 months after surgery were used to determine bone fusion. RESULTS: The most common mechanisms of trauma included falling from a height in 99 patients (68.7%), vehicle accidents in 39 patients (27.1%), and the most common fracture sites were the L1 vertebrae in 73 patients (50.7%), 111 patients (77.1%) had burst fractures, and 105 patients (72.3%) had no neurological defects (Frankel E). At the beginning of the study, there were no significant differences between the two groups regarding the mentioned data, patients' QOL, and pain severity. All patients (100%) had early mobilization. Most patients (85.4%) did not report persistent back pain 12 months after surgeries. 90.2% returned to their daily activities and all patients (100%) had full fusion based on radiologic data. The QOL and pain severity of patients improved significantly compared to baseline (P < 0.001 for both). CONCLUSION: The use or non-use of braces did not affect the treatment results. As a result, patients who have received pedicle screw fixation for unstable thoracolumbar fractures do not require braces in the postoperative period.

Spontaneous intracerebral hemorrhage, initial computed tomography (CT) scan findings, clinical manifestations and possible risk factors.

Intracerebral hemorrhage is one of the types of stroke in patients with risk factors. In this study, we aimed to evaluate the initial computed tomography (CT) scan findings, clinical manifestations and possible risk factors of patients with intracerebral hemorrhage. This is a cross-sectional study that was performed in 2015-2022 on 900 patients with definite diagnosis of intracerebral hemorrhage. Data of patients were evaluated for patient's age, gender, clinical manifestations, primary radiologic signs in CT scan and possible risks factors for stroke. Lobar hemorrhage was the most common site of involvement (324 patients, 36%) followed by lenticular (putamen) (294 patients, 32.7%) and thalamus (135 patients, 15%). Among patients, 543 patients (60.3%) had hypertension, 81 patients (9%) had histories of anticoagulant. Hemorrhages in putamen were significantly more common in patients with hypertension (P<0.001) and lobar hemorrhages were significantly more common in patients with the use of anticoagulant drugs (P=0.033). The most common presentation of hemorrhagic stroke was decreased consciousness level (428 patients, 47.5%) followed by headache (343 patients, 38.1%), coma (81 patients, 9%) and seizure (48 patients, 5.4%). Evaluation of the relationships between patient's main symptoms and sites of involvement showed that patients with decreased consciousness as their most common symptom had more frequently diagnosed with lobar hemorrhage (54%) and putamen hemorrhage (30.4%) (P<0.001). Hypertension was the most common past medical history that was significantly related to hemorrhage in basal nuclei. Hemorrhages in putamen were common in hypertensive patients and lobar hemorrhages were common in patients with anticoagulant use.

Correlations and diagnostic tools for metabolic syndrome (MetS) and chronic obstructive pulmonary disease (COPD).

BACKGROUND: Regarding the importance of obesity in patients with chronic obstructive pulmonary disease (COPD), we aimed to evaluate of correlation between metabolic syndrome (MetS) and COPD. METHODS: In this cross-sectional study, 96 patients with COPD were evaluated. This study was conducted in 2016-2018. The severity of COPD was determined by Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017 criteria. We investigated the correlations between MetS with COPD and possible diagnostic tools. RESULTS: Of all COPD patients, 86.5% had MetS, and the means of waist circumference, fasting blood glucose, systolic and diastolic blood pressure, body mass index, and triglyceride in patients with MetS were significantly higher than the patients without MetS (P < 0.05). We showed that forced expiratory volume in 1 second (FEV1) with a 37% cutoff had 92.8% and 69.2% sensitivity and specificity, respectively (area of the curve: 0.51, 0.31-0.71). CONCLUSION: MetS is prevalent among COPD and FEV1 could be considered as important diagnostic tool for COPD.

Comparison of susceptibility weighted imaging with conventional MRI sequences in multiple sclerosis plaque assessment: A cross-sectional study.

BACKGROUND: The current study was performed to compare susceptibility-weighted imaging (SWI) with magnetic resonance imaging (MRI) methods of T2-weighted (T2W) and fluid-attenuated inversion recovery (FLAIR) imaging in multiple sclerosis (MS) plaque assessment. MATERIALS AND METHODS: This cross-sectional study was conducted among 50 MS patients referred to Shafa Imaging Center, Isfahan, Iran. Patients who fulfilled McDonald criteria and were diagnosed with MS by a professional neurologist at least 1 year before the study initiation were included in the study. Eligible patients underwent brain scans using SWI, T2W imaging, and FLAIR. Plaques' number and volume were detected separately for each imaging sequence. Moreover, identified lesions in SWI sequence were evaluated in terms of iron deposition and central veins. RESULTS: Totally 50 patients (10 males and 40 females) with a mean age of 28.48 ± 5.25 years were included in the current study. Majority of patients (60%) had a disease duration of >5 years, and mean expanded disability status score was 2.56 ± 1.32. There was no significant difference between different imaging modalities in terms of plaques' number and volume (P > 0.05). It was also found that there was a high correlation between SWI and conventional imaging techniques of T2W (r = 0.97, 0.91, P < 0.001) and FLAIR (r = 0.99, 0.99, P < 0.001) in the estimation of both the number and volume of plaques (P < 0.001). CONCLUSION: The results of the present study indicated that SWI and conventional MRI sequences have similar efficiency for plaque assessment in MS patients.

The effects of occupational exposure to manganese fume on neurobehavioral and neurocognitive functions: An analytical cross-sectional study among welders.

This study aimed to measure concentrations of manganese fume in breathing zone (BZ) and blood among welders to assess neurocognitive and neurobehavioral functions among them. In this study 38 welders and 27 administrative employees participated. Q16 questionnaire was used to evaluate neurobehavioral symptoms. The computerized Stroop test and Continuous Performance Test (CPT) were used to assess neurocognitive functions. Sampling and analysis of manganese fumes in the BZ and blood samples were performed according to NIOSH-7300 and NIOSH-8005 methods, respectively. Average concentration of manganese in the welders' BZ and blood was 0.81 ± 0.21 mg/m3 and 18.33 ± 5.84 µg/l. Frequency of neurobehavioral symptoms was significantly higher in welders compared with control group. Spearman correlation test showed a moderate correlation between Mn concentrations in the BZ and blood Mn levels (rs = 0.352). There were statistical moderate and strong correlations between the frequency of neurobehavioral symptoms and manganese concentrations in the BZ (r=0.504) and blood Mn levels (r=0.643).The Pearson correlation coefficient (r=0.433-0.690) obtained on the psychological tests showed a moderate to strong correlation between manganese concentrations in the welders' BZ and blood and some indices of the Stroop test and CPT. The results of this study can confirm the effect of manganese inhalation on creating neurobehavioral and neurocognitive impairments in welders.

The Predicting Ability of Serum Phosphorus to Assess the Duration of Mechanical Ventilation in Critically Ill Patients.

BACKGROUND: No previous study exists to evaluate serum phosphorus (Ph) level as a predictor of the need to mechanical ventilation (MV). This study was designed to determine the predictive ability of admission serum Ph level on MV in patients admitted in Intensive Care Unit (ICU). MATERIALS AND METHODS: This prospective study was conducted on 100 patients (>16 years old), admitted to our ICU over 1-year. Patients were classified into two groups according to the days of the need to MV. Group A: Patients who required equal or <5 days MV, and Group B: Patients who required more than 5 days of MV. We measured total serum Ph concentrations at the times of ICU admission, connecting to the ventilator and weaning from the ventilator. RESULTS: There were significant differences between serum Ph concentration on admission to ICU (Group A: 3.39 ± 0.39 mg/dl, Group B: 2.89 ± 0.31 mg/dl, P < 0.001), at the time of connecting to ventilator (Group A: 2.49 ± 0.38 mg/dl, Group B: 2.25 ± 0.26 mg/dl, P = 0.004) and weaning from ventilator (Group A: 3.42 ± 0.33 mg/dl, Group B: 2.98 ± 0.34 mg/dl, P < 0.001) between two groups. Duration of ICU stay in Group A was 6.08 ± 1.48 days and in Group B was 15.35 ± 6.45, this difference was significant (P < 0.001). We found the best cut-off point of 3.07 for serum Ph concentration to predict the longer duration of MV. CONCLUSION: According to the results of our study, hypophosphatemia may increase the need to MV. Therefore, monitoring serum Ph level is a good prognostic factor to predict the need to ventilation.