Theoretical Spectroscopic Study of Normal Raman and Charge Transfer Surface-Enhanced Raman Scattering (SERS) Spectra of the Adsorbed l- and d-Cysteine on the Chiral Au34 and Ag4@Au30 Nanoclusters: Chirality Discrimination.

In this work, the discrimination of the enantiomers of cysteine (l- and d-CYS) using the chiral Au34 and Ag4@Au30 clusters was theoretically investigated in the gas phase and water. Two modes were considered for the interaction of each enantiomer with the clusters (via only its S atom or its S atom and NH2 group, simultaneously). The interaction energy (Eint) and adsorption energy (Ead) for the complexation of each enantiomer with the clusters for each interaction mode were calculated. Considering the calculated interaction energies, the interaction of d-CYS with Au34 is stronger than that of l-CYS with the same cluster. Also, it was observed that the substitution of the Au4 core of the Au34 cluster with the Ag4 cluster caused the increase of the interaction energy of l-CYS with the Ag4@Au30 cluster compared to the Au34 cluster, while the reverse trend was observed for d-CYS. Quantum theory of atoms in molecules (QTAIM) analysis was employed to calculate the interaction paths and their related bond critical points (BCPs) between the CYS enantiomers and the clusters to explain the difference between the interaction energy of the enantiomers with the clusters. The IR, normal Raman (NR), and surface-enhanced Raman scattering (SERS) spectra of the enantiomers interacting with the Au34 and Ag4@Au30 clusters were calculated, and the discrimination between l-CYS and d-CYS using the calculated spectra was explained. It was found that the discrimination of the enantiomers based on their interaction with the clusters is controlled by the charge transfer between the enantiomers and the clusters.

Hemicentral retinal vein occlusion in a patient with a history of coronavirus disease 2019 infection: a case report and review of the literature.

BACKGROUND: Considering the various manifestations of coronavirus disease 2019 and its imperative importance in terms of the right clinical approach and early management, we sought to present a hemicentral retinal vein occlusion case, with a history of heterozygosity of methylenetetrahydrofolate reductase (MTHFR) genes and potential for clotting complications as a late manifestation of coronavirus disease 2019, and provide a brief review of reported retinal vein occlusion cases in patients with coronavirus disease 2019. CASE PRESENTATION: A 35-year-old Iranian patient presented with a visual impairment in the left eye 4 months after recovering from coronavirus disease 2019. He reported a mild blurring of vision in the same eye a few days after admission due to coronavirus disease 2019. The ophthalmic evaluation was compatible with hemicentral retinal vein occlusion. Systemic and laboratory workups were negative except for borderline protein C activity, homocysteine levels, and heterozygosity of MTHFR genes. The patient was scheduled to receive three monthly intravitreal antivascular endothelial growth factor injections. CONCLUSION: We present a case of inferior hemicentral retinal vein occlusion case with an MTHFR mutation with sequential loss of vision 4 months after coronavirus disease 2019 to make clinicians aware of the possibility of late ocular coronavirus disease 2019 manifestations.

Intermolecular hydrogen bonding in DNA base pairs interacting with different numbers of bare and hydrated Li+: NBO, QTAIM, and computational spectroscopic studies.

In this study, the effect of different numbers of Li+ interacting with various sites of DNA base pairs (adenine-thymine (AT) and cytosine-guanine (GC)) on the base pair structures, the strength of hydrogen bonding between the bases, and spectroscopic properties (IR and absorption spectra) of the base pairs was investigated. Two quantum computational analyses, the natural bonding orbitals (NBO) and the quantum theory of atoms in molecules (QTAIM), were used to follow the change in the strength of hydrogen bonds between the bases in each pair. The type of base pair's site interacting with Li+ showed different effects on the change in the strength of the hydrogen bonds between the bases. The IR and absorption spectra of the lithiated base pairs were calculated and compared with those of bare base pairs. This comparison provided the changes in the spectra as a fingerprint for the structural identification of different lithiated base pairs. Also, the determination of the change in the strength of hydrogen bonds in the lithiated base pairs compared to their bare base pairs. In the other part of this study, the effect of the hydration of the attached Li+ in the structure of lithiated base pairs on the strength of their hydrogen bonds and spectra was investigated.

Orbital histiocytosis and fibrohistiocytosis: the clinicopathological characteristics of 117 patients, over a decade of experience.

PURPOSE: To describe the clinicopathological features of a large cohort of patients with orbital histiocytoses and fibrohistiocytosis, such as Langerhans cell histiocytosis (LCH) and non-LCH disorders, and correlate patients' clinical characteristics with their pathological diagnosis. METHODS: In this retrospective study, medical records of patients presenting to Farabi Eye Hospital, a tertiary eye care center in Tehran, Iran, from 2010 until 2022, were reviewed. Patients' demographics, chief complaint, location and laterality of the tumor, best-corrected visual acuity, presence of bone erosion on imaging, and their pathological diagnosis were retrieved. Excisional biopsy was performed and evaluated through light microscopy and immunohistochemistry study for their respective markers, including CD1a, CD68, CD207, and S100. RESULTS: A total of 117 patients with 11 pathological subtypes of histiocytoses and fibrohistiocyosis were identified, with 56.4% male and 43.6% female patients. The mean age at presentation was 23.4 years (range 1.5 months-73 years). Swelling and palpable mass were the most common chief complaints. LCH was the most common pathology (32.5%), followed by juvenile xanthogranuloma (26.5%) and adult xanthogranuloma (21.4%). Age, lesion location, and bone erosion had a statistically significant difference among the various diagnosed subtypes. CONCLUSIONS: Histiocytoses and fibrohistiocytosis are diverse and rare disorders potentially involving multiple organ systems. Ophthalmic manifestations of these diseases are even more uncommon. We reviewed their orbital presentation along with their respective histopathological findings. Our results also suggested that an orbital CT scan can be of diagnostic value to discriminate LCH from other histiocytic pathologies.

A curcumin-nicotinoyl derivative and its transition metal complexes: synthesis, characterization, and in silico and in vitro biological behaviors.

Curcumin-nicotinoyl (Cur-Nic) was synthesized by the chemical modification of the curcumin structure, characterized, and used as a ligand for the synthesis of copper(II) and zinc(II) complexes. The biological activities of Cur-Nic and its metal complexes were predicted using the PASS and Swiss Target Prediction online software, respectively, and docking studies with tyrosine-protein kinase SRC were performed using the PyRx software to predict their anticancer activities. The toxicity effects of the complexes on a human breast cancer cell line (MCF-7) compared to a healthy breast cell line (MCF-10A) were investigated by the MTS assay. Although the metal complexes maintained the least toxicity against normal cells, the results indicated that compared to curcumin and Cur-Nic, the cytotoxicity toward cancer cells increased due to the complexation process. Moreover, the antibacterial evaluation of the compounds against a Gram-positive bacterium (MRSA) and a Gram-negative bacterium (E. coli) indicated that the Cu(II) complex and Cur-Nic were the best, respectively. Also, the Zn(II) complex was the most stable compound, and the Cu(II) complex was the best ROS scavenger based on the in vitro evaluation.

A Case Series of Infectious Keratitis After Corneal Cross-linking.

PURPOSE: To present the 7-year experience of a tertiary eye hospital while exploring possible risk factors and incidence of infectious keratitis in patients undergoing standard corneal cross-linking (CXL). METHODS: This retrospective cohort study included patients with progressive keratoconus undergoing standard CXL in the Farabi Eye Hospital and all other patients who had undergone CXL in other facilities and were diagnosed as having infectious keratitis in the 7-year period of the study. RESULTS: Among the total of 4,863 eyes that underwent CXL, 6 eyes developed infectious keratitis, yielding an incidence rate of 0.12%. Additionally, 13 eyes from 10 patients with a CXL history in other facilities who developed infectious keratitis were included. The mean age was 23.75 years, and 75% of patients were men and 25% were women. Gram-positive bacteria and Staphylococcus aureus were the most prevalent pathogens. Meibomian gland dysfunction, dry eye disease, or blepharitis were present in 12 patients. Medical treatment did not arrest the disease progress in 5 patients, which eventually required cases to undergo keratoplasty. CONCLUSIONS: This study supports the need for proper patient selection by using a comprehensive medical history. It also highlights the imperative role of rigorous patient education and follow-up, particularly in the first postoperative week. Finally, the study emphasizes aggressive early therapy for patients with suspicious findings. [J Refract Surg. 2023;39(8):564-572.].

Charge Transfer Surface-Enhanced Raman and Absorption Spectra of the Zwitterionic Form of Cysteine Adsorbed on M@Au12 (M = Au, Ag, Pt, and Pd) Nanoclusters.

The effect of the core atom type of the M@Au12 nanocluster (M = Au, Ag, Pt, and Pd) on the normal (NR) and charge-transfer surface-enhanced Raman spectroscopy (CT-SERS) of the zwitterion form of l-cysteine (ZWCYS) adsorbed on two different sites (D1 and D2) of the nanocluster is investigated separately in the gas phase and water. Because SERS requires the calculation of the absorption spectrum, the effect of the core atom type on the absorption spectrum of M@Au12 and its complex with the ZWCYS has also been investigated. The vibrational bands that show the intensity enhancement in the CT-SERS of the ZWCYS interacting with the D1 site of M@Au12 nanocluster in water are O─C═O asymmetric stretching (M = Au and Ag), NH2 bending (M = Ag), S-H stretching (M = Ag, Pt, and Pd), CH2 bending (M = Pt), and CH2 symmetric stretching (M = Pt and Pd). The ZWCYS at the D2 site of the M@Au12 nanocluster in water exhibits intensity enhancement for O─C═O asymmetric stretching (M = Pt), NH3 wagging (M = Au), and S-H stretching (M = Pd). The intensity of the vibrational bands of ZWCYS does not increase for M = Ag but decreases for O─C═O asymmetric stretching, S-H stretching, CH2 symmetric stretching, CH2 asymmetric stretching, and especially NH2 symmetric stretching.

A combined experimental and theoretical study of RuO2/TiO2 heterostructures as a photoelectrocatalyst for hydrogen evolution.

We report a joint experimental and theoretical study of RuO2/TiO2 heterostructures. In the experimental section, mesoporous RuO2/TiO2 heterostructures were prepared by impregnation of mesoporous TiO2 nanoparticles which were synthesized from a new precursor, Na2[Ti(C2O4)3], in an aqueous solution of ruthenium(III) chloride followed by calcination at 300 °C. Using various techniques, the prepared TiO2 and RuO2/TiO2 heterostructures were extensively characterized. The photoelectocatalytic application of the as-prepared heterostructures was then investigated toward the hydrogen evolution reaction (HER). The results illustrated that RuO2 is dispersed uniformly on the TiO2 surface. The loading of RuO2 on TiO2 decreases the band gap energy and extends the absorption edge to the visible light region. This wide absorption extends the photoelectrocatalytic activity of RuO2/TiO2 heterostructures. To obtain a deeper understanding of the increase of the photoelectrocatalytic activity of RuO2/TiO2 heterostructures compared to pure TiO2, theoretical calculations at the density functional theory (DFT) level were performed on some model clusters of pure TiO2 and the RuO2/TiO2 heterostructure. The theoretical results elucidated that the recombination ratio of electron-hole pairs decreases effectively for RuO2/TiO2 compared to pure TiO2.

Population attributable fraction estimates of cardiovascular diseases in different blood pressure levels in a large-scale cross-sectional study: a focus on prevention strategies and treatment coverage.

OBJECTIVE: Hypertension is one of the major modifiable risk factors in developing cardiovascular diseases (CVD). Hence, we aimed to ascertain age- and sex-specific population attributable fraction (PAF) for CVD in different blood pressure levels to implement efficient preventive strategies at the population level. METHODS: Participants' data were obtained from the Iranian stepwise approach for surveillance of noncommunicable disease risk factors (STEPs) survey to calculate PAF in four subsequent phases. In phase 0, PAF was measured, irrespective of the diagnosis status. In phase 1, the theoretical minimum range of 115 ≤SBP less than 130 mmHg was considered as the low-risk and measurements equal to or higher than 130 mmHg as the high-risk group. Across phase 2, patients were divided into normal and hypertensive groups based on the American College of Cardiology/American Heart Association guideline. In phase 3, patients were divided into two categories based on treatment coverage. RESULTS: A total number of 27 165 participants aged ≥25 years had valid blood pressure measurements and were enrolled. Phase 0: PAF generally had an upward trend with age advancing. Phase 1: participants with BP ≥130 mmHg comprised the largest PAF, extending from 0.31 (0.25-0.37) in older male individuals to 0.85 (0.79-0.91) in younger females. Phase 2: higher values were found in younger ages for hypertension. Phase 3 represented that attributable fractions among hypertensive patients who received treatment were much lower than drug-naïve hypertensive participants. CONCLUSION: Our study enlightens the necessity for implementing effective screening strategies for the younger generation and providing adequate access to antihypertensive medications for the low-risk population.

Substrate-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry of Some Small Biomolecules Using TiO2-Nanotubes: The Effect of Nanotube Diameter and Salt Addition.

Substrate-assisted laser desorption/ionization (SALDI) is a kind of soft ionization method that is most suitable for the analysis of low molecular weight analytes when it is coupled with a time-of-flight mass spectrometer. Unlike the conventional matrix-assisted laser desorption/ionization, there is no interference in the SALDI with matrices for the low mass analyte peaks (m/z < 700). The focus of this work is to develop substrates based on nanomaterials to obtain higher sensitivity, better reproducibility, and easier preparation. The mass spectra of some small molecules (capecitabine, hemin, methadone, noscapine, oxycodone, thebaine, malathion, chlorpyrifos, ethion, permethrin, and phosalone) deposited on the TiO2-nanotube (TiO2-NTs) plate by the SALDI-TOF-MS technique are reported. The nanotubes are synthesized in different diameter sizes of nanotubes via the anodizing method. The intensity of the analyte peaks and the softness of ionization are optimized by varying the diameter of nanotubes and adding relevant alkali salts to the analytes. In addition, the reproducibility of the signal intensity of analytes is optimized by changing the surface hydrophilicity of the TiO2-NT plate.

Meta-Analysis on the Association Between Nutritional Status and Outcomes After Transcatheter Aortic Valve Implantation.

Malnutrition is a common co-morbidity among candidates for transcatheter aortic valve implantation (TAVI). This study aimed to investigate the association between nutritional status determined by objective nutritional indices and outcomes of patients who underwent TAVI. We systematically searched PubMed, Embase, Web of Science, Scopus, and Cochrane Library from inception until April 18, 2022 to identify studies examining the association of preprocedural nutritional status with post-TAVI outcomes. Malnutrition was defined by objective nutritional indices-controlling nutritional index, nutritional risk index, geriatric nutritional risk index (GNRI), and prognostic nutritional index (PNI). The primary end point was 1-year all-cause mortality. The review included 13 observational studies and 6,785 patients who underwent TAVI. Malnutrition was associated with a higher risk of 1-year all-cause mortality, as defined by either the controlling nutritional index (hazard ratio [HR] 2.70, 95% confidence interval [CI] 1.21 to 6.03, p = 0.015), GNRI (HR 1.79, 95% CI 1.09 to 2.93, p = 0.021), or PNI (HR 1.17, 95% CI 1.11 to 1.23, p <0.001). In the meta-analysis of adjusted results, lower GNRI was independently associated with higher 1-year mortality (HR 1.70, 95% CI 1.16 to 2.50, p = 0.006). Lower GNRI was associated with increased risk of acute kidney injury (relative risk [RR] 2.21, 95% CI 1.63 to 2.99, p <0.001) and 1-year cardiovascular mortality (RR 2.50, 95% CI 1.66 to 3.78, p <0.001). Lower PNI was associated with a higher risk of major vascular complications (RR 2.99, 95% CI 1.38 to 6.51, p = 0.006). In conclusion, baseline malnutrition, as assessed by objective indices, is associated with worse outcomes after TAVI. Future studies should focus on the value of nutritional assessment and interventions to improve nutritional status in patients who underwent TAVI.

Post photorefractive keratectomy (PRK) infectious keratitis; six-year experience of a tertiary eye hospital.

BACKGROUND/OBJECTIVES: As an essential development in the new century, surface ablation procedures have attracted increasing attention. There exists a concern regarding the risk of infectious keratitis. Hence, we aimed to investigate the rate and predisposing factors of infectious keratitis after photorefractive keratectomy (PRK). SUBJECTS/METHODS: This retrospective study was designed in two phases. First, the rate of post-PRK keratitis of Farabi Eye Hospital was investigated. In other words, the targeted population was the patients who developed keratitis after performing procedure at Farabi Eye Hospital. In the second phase, all the patients with the diagnosis of post-PRK keratitis were studied regardless of the centre where surgery was performed. Patients with the diagnosis of infectious keratitis between 2014 and 2020 were enrolled and following information was analyzed: demographics, presentation time after surgery, perioperative medications, culture results, risk factors, medical treatment, complications, and final visual acuity. RESULTS: The total number of PRK procedures in our centre was 24,986 (13,253 patients), in which 6 eyes of 5 patients developed keratitis. Beside these 5 patients, 24 referred patients (24 eyes) from the other centres were enrolled. Finally, a total number of 29 patients (30 eyes) were included. Our analysis revealed that manipulation of contact lens, dry eye, and blepharitis were the essential predisposing factors for keratitis development. CONCLUSION: The overall post-PRK keratitis occurrence rate of our study was 0.02%. Our observation highlighted the importance of preoperative examination and treatment of the lids and dry eye disease.

Evaluation of the Practice Guideline Used for Rule-Out of Myocardial Infarction at a Tertiary Cardiology Center.

INTRODUCTION: With the current high burden on the healthcare system and limited resources, the efficient utilization of facilities is of utmost importance. We sought to present the practice guideline used at a high prevalence tertiary cardiology center and compare its safety and efficacy performance with the single high-sensitivity cardiac troponin T strategy, conventional and modified HEART score. METHODS: In this prospective cohort study, consecutive patients presenting to the emergency department with chest pain or an angina equivalent were recruited. The primary endpoints consisted of major adverse cardiac events at index visits and 30-day follow-up. Patients were managed according to the practice guideline, and sensitivity and negative predictive values were compared. RESULTS: Of the total 1548 patients, the mean age was 50.4 ± 15.7 years. Ninety-nine (10.9%) patients were admitted at the index visit, and 89 patients were consequently diagnosed with acute coronary symptoms. Six (0.007%) patients experienced major adverse cardiac events within the 30-day follow-up among discharged patients. Among 911 patients with at least 1 troponin, using single high-sensitivity cardiac troponin T, HEART score, and modified HEART score would have further admitted 805, 450, and 609 patients, respectively. The negative predictive value for all 4 algorithms did not significantly differ (99.2% vs. 100% vs. 99.3% vs. 99.6%, respectively). CONCLUSIONS: The Tehran Herat Center protocol was a relatively safe protocol with high efficacy. Despite the high safety of the other diagnostic pathways, the high volume of patients needing additional evaluation could impose a high burden on the health care system.

Herpetic endotheliitis and stromal keratitis following inactivated COVID-19 vaccination.

Given the scarcity of data regarding ocular complications following COVID-19 vaccination, the approach toward patients with suggestive symptoms and established clinical practice is lacking. Herein, we report the first case of herpetic endotheliithis and secondary stromal keratitis following inactivated COVID-19 vaccination who experienced a relapse due to poor adherence.

Interaction between the Human OX2 Orexin Receptor and Suvorexant and Some of Its Analogues: SAPT (DFT) Interaction Energy Decomposition Analysis.

In this study, the interaction energy (Eint) of suvorexant (as an orexin receptor antagonist) and some of its analogues with the important residues of the human OX2 orexin receptor, determined by molecular docking, is calculated using the symmetry-adapted perturbation theory-density functional theory (SAPT (DFT)) method. Also, the important residues with the dominant interaction with each ligand are determined based on the obtained SAPT (DFT) interaction energies. To analyze the interaction of the receptor with each ligand, the decomposition of Eint to its constituent components including electrostatic (Eele), exchange (Eex), induction (Eind), and exchange-induction (Eex-ind), dispersion (Edisp), and exchange-dispersion (Eex-disp) is performed. The change of interaction energy components with the replacement of the benzoxazole part of suvorexant by pyrimidine containing different functional groups, thieno pyrimidine, and furo pyrimidine is also investigated, separately. It is found that the change in Eint, due to these replacements, is controlled more by the variation of the electrostatic interaction energy component of Eint than by the other interaction energy components. A linear correlation (R2 = 0.91) is found for the variation of Eint versus experimental ligand-binding affinities. Also, the existence of the linear correlation for the variation of the interaction energy components with experimental ligand-binding affinities is investigated. The variation of the electrostatic component versus experimental ligand-binding affinities shows a more linear correlation compared to the other interaction energy components.

Circular RNA MYLK as a prognostic biomarker in patients with cancers: A systematic review and meta-analysis.

BACKGROUND: Circular RNA (circRNA) myosin light chain kinase (circMYLK) has recently received increasing attention in cancer biology. Several studies have suggested that circMYLK expression is linked to prognosis and clinicopathological characteristics of various malignancies. AIMS: This study was carried out to systematically review the impact of circMYLK on the progression of multiple cancers and assess the significance of circMYLK in the prognosis and clinicopathological features of the patients. METHODS: PubMed, Web of Science, and Embase were systematically searched until July 2, 2021. For qualitative synthesis, the signaling pathways of circMYLK in the progression of different cancers were summarized. Regarding the meta-analysis, overall survival (OS) and eight clinicopathological characteristics of patients with cancers were addressed. Odds ratios (ORs) and hazard ratios (HRs) were calculated to assess the association of circMYLK with prognostic and clinicopathological features. RESULTS: Twelve studies investigating the role of circMYLK in cancer progression met the inclusion criteria. Among these, seven studies investigated the prognostic significance of circMYLK, and nine studies ascertained the clinicopathological importance of circMYLK in patients with various malignancies. CircMYLK acts as a tumor promoter circRNA, leading to migration, proliferation, invasion, and metastasis of neoplastic cells and inhibiting their apoptosis through interaction with several miRNAs and corresponding downstream signaling pathways. Overexpression of circMYLK was correlated with poor OS (HR = 1.75; 95% confidence interval [CI] 1.52-2.02) and larger tumor size (OR = 2.90; 95% CI 1.03-8.15), higher T stage (OR = 2.49; 95% CI 1.20-5.18), lymph node metastasis (OR = 2.55; 95% CI 1.41-4.62), and higher TNM stage (OR = 4.62; 95% CI 2.99-7.14). CONCLUSIONS: CircMYLK is involved in the progression of numerous cancers via different signaling pathways. This circRNA can serve as a promising prognostic biomarker for several types of malignancies. Furthermore, high expression of circMYLK is associated with advanced clinicopathological characteristics in various tumors.

Imine-Linked Covalent Organic Framework with a Naphthalene Moiety as a Sensitive Phosphate Ion Sensing.

Due to the excellent ion-sensing potential of covalent organic frameworks (COFs), the new imine-linked conjugated COF (IC-COF) is synthesized through a water-based synthesis reaction between 1,5-diaminonaphthalene and 2,4,6-tris(4-formylphenoxy)-1,3,5-triazine to create a luminescence sensor. It is noteworthy that the green synthesized IC-COF shows excellent selectivity to phosphate ions (PO43-) with a detection limit of 0.61 µM. The recyclability performance of IC-COF is high, indicating that it can be reused without a significant reduction in performance (5.2% decline after 5 cycles). Theoretical calculations using the density functional theory are performed on the IC-COF-PO43- and IC-COF-Cu+ complexes to explore the sensing mechanism. The fluorescence quenching in the presence of PO43- ions is attributed to the difference between PO43- binding sites to the IC-COF compared to Cu+, which leads to the considerable change in the IC-COF absorption spectrum from 400 to 600 nm.

Oncologic outcomes of Bacillus Calmette-Guérin therapy in elderly patients with non-muscle-invasive bladder cancer: A meta-analysis.

INTRODUCTION: There is a challenge on the medical efficacy of intravesical Bacillus Calmette-Guérin (BCG) therapy and the power of the immune system boosting, which can be influenced by the age of the non-muscle-invasive bladder cancer (NMIBC) patients. This meta-analysis evaluates the efficacy of BCG therapy among aged (>70) and younger patients with non-muscle-invasive bladder cancer (NMIBC). METHODS: The central database of PubMed, Scopus, and Web of Science were queried until August 4, 2021, by using "BCG," "Bladder Cancer," "AGE," and "efficacy" keywords. After excluding duplicated results, titles and abstracts were evaluated by two independent reviewers. The exclusion criteria included non-English studies, conference abstracts, reviews, editorials, letters, and comments. Three main outcomes, disease-free survival (DFS), progression-free survival (PFS), and cancer-specific survival (CSS), were considered. The statistical analysis was performed using STATA (version 14; Stata Corp, College Station, Texas, USA). RESULTS: From 1115 found documents, the 24 research articles were recruited in the systematic review, and 10 were the candidate for meta-analysis. The overall estimate of H.R. revealed that BCG therapy in those over age 70 is significantly associated with an improved risk of progression and cancer-specific death in studied patients. However, this association was not statistically significant for DFS (1.04 (95% CI: 0.85,1.26)). CONCLUSION: The BCG maintenance therapy improved CSS and PFS oncological outcomes in elderly patients with NMIBC. BCG therapy did not significantly change the DSF.

Long-Term Impact of the COVID-19 Associated AKI: The Relationship between Kidney Recovery and Mortality in a 10-Month Follow-Up Cohort Study.

INTRODUCTION: Coronavirus-2019 disease (COVID-19)-associated acute kidney injury (AKI) and its short and mid-term effect on kidney has been well established in the previous literature, indicating a high number of AKI in hospitalized patients associated with high rates of mortality, followed by high rates of unresolved kidney injury at the time of discharge. However, the long-term impact of AKI and its resulting lack of recovery at the time of discharge has not been investigated. Herein, we sought to explore the possible relationship between AKI and unresolved kidney injury and post-discharge mortality. METHOD: In this cohort study, patients hospitalized with COVID-19 who survived until discharge were followed for a median of 9.6 months. AKI during hospitalization based on the staging according to Kidney Disease: Improving Global Outcomes (KDIGO) criteria and kidney injury status at discharge and other comorbidities and mortality during the follow-up period were recorded. The desired association was investigated using Cox proportional hazards regression after adjustment for potential confounders. RESULT: Among 1,017 discharged patients, 298 patients (29.3%) experienced AKI during hospitalization according to KDIGO criteria, of whom 178 patients (59.7%) were diagnosed with unresolved kidney injury at the time of discharge. After adjusting for potential confounders, Cox regression indicated that AKI stage 3 (hazard ratio (HR): 4.56, 95% confidence interval (CI): 1.89-10.99, p = 0.001) and unresolved kidney injury at the time of discharge (HR: 2.09, 95% CI: 1.18-3.73, p = 0.011) were significantly associated with mortality during the post-discharge period. Additionally, Kaplan-Meier curves for overall survival indicated an increased risk of mortality in patients with stage 2, stage 3 AKI, and unresolved kidney injury at the time of discharge (p < 0.001). CONCLUSION: Overall, it was shown that patients with COVID-19 who develop AKI, mainly stage 2 and 3, and patients with unresolved kidney injury at the time of discharge, were at an increased risk of mortality, even after hospitalization for an extended period of time.