Classification and Diagnostic Prediction of Colorectal Cancer Mortality Based on Machine Learning Algorithms: A Multicenter National Study.

INTRODUCTION: Colorectal cancer (CRC) ranks as the second leading cause of cancer-related deaths. This study aimed to predict survival outcomes of CRC patients using machine learning (ML) methods. MATERIAL AND METHODS: A retrospective analysis included 1853 CRC patients admitted to three prominent tertiary hospitals in Iran from October 2006 to July 2019. Six ML methods, namely logistic regression (LR), Naïve Bayes (NB), Support Vector Machine (SVM), Neural Network (NN), Decision Tree (DT), and Light Gradient Boosting Machine (LGBM), were developed with 10-fold cross-validation. Feature selection employed the Random Forest method based on mean decrease GINI criteria. Model performance was assessed using Area Under the Curve (AUC). RESULTS: Time from diagnosis, age, tumor size, metastatic status, lymph node involvement, and treatment type emerged as crucial predictors of survival based on mean decrease GINI. The NB (AUC = 0.70, 95% Confidence Interval [CI] 0.65-0.75) and LGBM (AUC = 0.70, 95% CI 0.65-0.75) models achieved the highest predictive AUC values for CRC patient survival. CONCLUSIONS: This study highlights the significance of variables including time from diagnosis, age, tumor size, metastatic status, lymph node involvement, and treatment type in predicting CRC survival. The NB model exhibited optimal efficacy in mortality prediction, maintaining a balanced sensitivity and specificity. Policy recommendations encompass early diagnosis and treatment initiation for CRC patients, improved data collection through digital health records and standardized protocols, support for predictive analytics integration in clinical decisions, and the inclusion of identified prognostic variables in treatment guidelines to enhance patient outcomes.

Anti-Staphylococcal and cytotoxic activities of the short anti-microbial peptide PVP.

Over the past years, short anti-microbial peptides have drawn growing attention in the research and trade literature because they are usually capable of killing a broad spectrum of pathogens by employing unique mechanisms of action. This study aimed to evaluate the anti-bacterial effects of a previously designed peptide named PVP towards the clinical strains of methicillin-resistant Staphylococcus aureus (MRSA) in vitro. Secondary structure, cytotoxicity, and membrane-permeabilizing effects of the peptide were also assessed. PVP had a tendency to adopt alpha-helical conformation based upon structural predictions and circular dichroism spectroscopy (in 50% trifluoroethanol). The peptide showed MIC values ranging from 1 to 16 µg/mL against 10 strains of MRSA. In contrast to ciprofloxacin and gentamicin, PVP at sub-lethal concentration (1 µg/mL) did not provoke the development of peptide resistance after 14 serial passages. Remarkably, 1 h of exposure to 4 × MBC of PVP (8 µg/mL) was sufficient for total bacterial clearance, whereas 4 × MBC of vancomycin (8 µg/mL) failed to totally eradicate bacterial cells, even after 8 h. PVP showed negligible cytotoxicity against human dermal fibroblasts at concentrations required to kill the MRSA strains. The results of flow cytometric analysis and fluorescence microscopy revealed that PVP caused bacterial membrane permeabilization, eventually culminating in cell death. Owing to the potent anti-bacterial activity, fast bactericidal kinetics, and negligible cytotoxicity, PVP has the potential to be used as a candidate antibiotic for the topical treatment of MRSA infections.

Gestational Diabetes Mellitus Regulatory Network Identifies hsa-miR-145-5p and hsa-miR-875-5p as Potential Biomarkers.

BACKGROUND: Gestational diabetes mellitus (GDM) is pregnancy-related diabetes with vital risks for both mother and the fetus. Molecular studies represent one of the popular approaches for investigating mechanisms associated with the disease nature. One of which is through interaction network analysis via Cytoscape V. 3.6.1. METHODS: In this study, the microRNA (miRNA) expression array of GSE98043 from gene expression omnibus (GEO) database was retrieved and screened. We identified 12 differentially expressed (DE) miRNAs (P ≤ 0.05) and nine target hub-bottleneck genes (disease score > 1) for GDM based on miRNA-target interactions created via plugin ClueGO + Cluepedia + STRING. RESULTS: MiRNA-target information showed that the miRNAs are mostly up-regulated and hsa-miR-145-5p and hsa-miR-875-5p targets the most genes. Among target genes, IL6, GCG, APOB, and ALB have the highest associations with DE-miRNAs. Gene ontology analysis based on biological processes identification via ClueGO + CluePedia, in addition, showed that target hub-bottlenecks are mainly related to metabolism functions and any changes in this regulatory network could impose fundamental alterations in these processes. CONCLUSIONS: It can be concluded that via these introduced miRNAs and their targets, the molecular tests for diagnosis and treatment of GDM can be improved after applying validation approaches.

Subclinical atherosclerosis and cardiovascular markers in patients with lichen planus: A case-control study.

BACKGROUND: Lichen planus is an idiopathic and chronic inflammatory disease that affects the skin and the mucous membranes, and has been associated with an increased risk for cardiovascular diseases. Hyperhomocysteinemia has been regarded as a risk factor for atherosclerosis and cardiovascular diseases. Increased plasma fibrinogen levels are also associated with increased risk of myocardial infarction. OBJECTIVE: The main aim of this study is the evaluation of common carotid artery mean intima media wall thickness, serum fibrinogen and homocysteine levels in patients with lichen planus. METHODS: Forty-three patients with lichen planus and 43 age, gender and body mass index (BMI) matched healthy controls (from general population without the disease) were included in this study. RESULTS: Compared to the healthy controls, patients had statistically significant greater mean intima media wall thickness of the common carotid artery. Moreover, a positive correlation was observed between lichen planus and increased serum homocysteine and c-reactive protein levels. LIMITATIONS: The main limitation of this study is the small sample size due to the time limitation and financial constraints. CONCLUSION: Early diagnosis of atherosclerosis in patients with lichen planus might afford better prophylaxis, including weight control and/or lipid profile monitoring. Measurement of the mean intima media wall thickness of the common carotid artery by duplex high-resolution B-mode ultrasound scanning could be beneficial as a valuable method for early diagnosis of atherosclerosis in lichen planus.

Introducing Genes With Significant Role in Migraine: An Interactomic Approach.

INTRODUCTION: Migraine is a severe kind of headache with the chance hereditary of 50%. Molecular studies can promote understanding of migraine pathophysiology. One of which is bioinformatics approach that could provide additional information related to the identified biomarkers. METHODS: In this research, migraine genes are studies in terms of interaction pattern to introduce important individuals. Through STRING database Plug-in in Cytoscape, candidate genes for migraine were retrieved and analyzed by related applications. Based on centrality and action types (expression, activation, and inhibition) genes were screened. RESULTS: Numbers of 33 central genes including seven hub-bottlenecks were identified which 70% of central genes were involved in expression action with each other. Activation was dominate action relative to inhibition between the central genes. CONCLUSION: The finding indicates that insulin is the most important gene relative to migraine. It seems regulation of metabolism play critical role in control of migraine.

Ocular Surface Findings in Patients With Lichen Planopilaris.

PURPOSE: Lichen planopilaris (LPP) is a chronic lymphocytic- mediated disorder that selectively involves hair follicles, leading to cicatricial alopecia. The eyelash follicle and meibomian gland (MG) might also be involved in the disease process leading to ocular surface problems. METHODS: In this Cross-sectional case -control study, twenty-three patients with histologically confirmed LPP and 23 healthy controls were recruited in this controlled study. To quantify the signs and symptoms of LPP, we used the Lichen Planopilaris Activity Index. The ophthalmologic examination was performed by the same ophthalmologist at Farabi Eye Hospital. RESULTS: Patients with LPP had a statistically significant lower tear breakup time (worse test outcome) compared with the control (7.1 6 4.1 vs. 9.6 6 4.4; respectively, P = 0.011). Both MG quality score and expressibility were higher in patients with LPP than in control subjects (14.1 6 4.3 vs. 9.3 6 4.4; P = 0.001; 1.5 6 1.0 vs. 0.4 6 0.8; P = 0.001; respectively). The Schirmer test score was not different between groups. A significant but weak correlation was found between the Lichen Planopilaris Activity Index and tear breakup time. Other ophthalmologic examinations including conjunctiva, lid margin shape, intraocular pressure, and funduscopy were normal in patients with LPP. CONCLUSIONS: Patients with LPP, scored worse in ocular surface tests. This finding warrants special scrutiny for dry eye and MG dysfunction in these patients.

Mucosal manifestations of pemphigus vulgaris in ear, nose, and throat; before and after treatment.

BACKGROUND: Pemphigus vulgaris (PV) is a life-threatening autoimmune bullous disease, mediated by autoantibodies directed against antigens on the keratinocyte cell surface of stratified squamous epithelia. The frequency of ear, nose, and throat (ENT) involvement in PV is not clearly identified. OBJECTIVE: We sought to evaluate the ENT involvement in new patients with PV examined by ENT endoscopy before and after treatment. METHODS: This study included 41 new patients with PV. All patients were evaluated for ENT manifestations by otoscopic and endoscopic examination before treatment. After these examinations, the patients received proper treatment according to standard protocols. Thirty patients were re-evaluated by endoscopic examination after clinical remission of mucocutaneous signs. RESULTS: A total of 41 (33 [80.5%] male and 8 [19.5%] female) patients with mean age of 44.56 ± 12.76 years entered this study. In ENT examination of patients before the treatment, 11 (26.8%) patients showed ear, 15 (36.6%) nasal, 37 (90.3%) oral, 25 (61%) pharyngeal, and 24 (58.5%) laryngeal involvement. Thirty patients underwent the posttreatment ENT examination. We found ear signs in 2 (6.7%), nasal involvement in 1 (3.3%), oral signs in 4 (13.3%), pharyngeal manifestations in 6 (20%), and laryngeal signs in 3 (10%) patients after treatment. The treatment was significantly effective in the improvement of mucosal lesion in different sites (P < .01). LIMITATION: Eleven patients refused to undergo posttreatment ENT examination. CONCLUSION: ENT evaluation may be worthwhile to evaluate the disease extension in patients with PV more definitely and exclude other potential etiologies in recalcitrant patients.

Auricular enlargement: an atypical presentation of old world cutaneous leishmaniasis.

The auricle is an extremely rare site for cutaneous leishmaniasis (CL) in Old World, which tends to be a benign disease with self-healing small nodules such as the "oriental sore". However, in the New World, there is a type of CL of the ear, named as "chiclero's ulcer" which is caused by Leishmania mexicana. Herein, we describe a case of massive auricular enlargement due to Old World CL.

Comparison of two surgical methods (Winograd and sleeve method) in the treatment of ingrown toenail.

BACKGROUND: Ingrowing toenail is one of the most common nail complaints. Although many surgical treatments are described for complicated nails, frequent recurrence of pain and postoperative disability necessitate finding an appropriate treatment. METHODS: In a clinical trial, we compared the Winograd and sleeve (gutter) surgical methods to find a simple, painless, and practical alternative. RESULTS: Of 100 patients (mean 27.8) included in the study, 50 underwent Winograd surgery and the rest the sleeve method. Postoperative infection occurred in four (8%) patients in the sleeve and three (6%) in the Winograd group. The condition reoccurred in five (10%) patients who underwent sleeve surgery and six (12%) who underwent Winograd. Recurrence rate was higher in female patients, although the difference was not statistically significant. Mean surgery duration for Winograd and sleeve methods was 15.7 minutes and 9.4 minutes, respectively, and postoperative work day loss was 2.0 weeks and 1.1 weeks, respectively. CONCLUSION: The sleeve method seems to be more practical and appropriate for patients planning to go back to work sooner and better fulfills the main characteristics for the primary treatment of choice. The authors have indicated no significant interest with commercial supporters.

Facial and bilateral acral porokeratosis with nail dystrophy: A case report.

Porokeratosis is a rare disorder of keratinization with unknown etiology. It exhibits both sporadic and autosomal dominant inheritance. The lesions are sharply demarcated, hyperkeratotic, and annular with distinct keratotic edges. The cornoid lamella is the histological hallmark of porokeratosis. Porokeratosis lesions on the face may have a superficial or a destructive nature. To our knowledge there are only a few cases of facial porokeratosis that have been reported. We report a sporadic form of facial and bilateral acral porokeratosis with nail dystrophy.

Solitary cutaneous leiomyoma in an infant.

This report describes a case of leiomyoma of the ankle occurring at an unusual age. A 5-month-old girl presented with an asymptomatic nodule on her left ankle.

Four familial cases of epidermodysplasia verruciformis: mother and three sons.

Epidermodysplasia verruciformis (EV) is a rare genodermatosis associated with a high risk of skin cancer. In this report, we present three Iranian brothers and their mother with extensive seborrheic keratosis-like (SK-like) viral warts. Initial facial lesions developed in the first decade and disseminated with time. The patients showed SK-like viral warts characterized by dark brown or black pigmented proliferative lesions with hyperkeratotic surfaces. The histopathological findings were consistent with the diagnosis of EV. There are few reports of familial epidermodysplasia verruciformis especially in a mother and her three sons.

A dilemma: bullous-pemphigoid-like eruption in scabies or scabies-induced bullous pemphigoid.

Several diseases may be confused with scabies. Atypical manifestations of scabies have previously been reported, including urticaria, contact dermatitis, and dermatitis herpetiformis. There are also reports of scabies mimicking bullous pemphigoid. Here we report a case of scabies in a patient with manifestation similar to bullous pemphigoid. Direct smear of the bullous lesions was performed and was positive for scabies mites. The skin biopsy specimens submitted for light microscopy and direct immunofluorescence study were considered to be compatible with bullous pemphigoid. The patient treated with single dose oral ivermectin and prednisolone. The pruritus subsided and the eruption improved dramatically in 2 weeks.

Lipoid proteinosis: report of three familial cases.

Lipoid proteinosis is a rare autosomal recessive disorder; it presents in early childhood with hoarseness, skin infiltration and thickening with beaded papules on eyelid margins, and facial acneiform or pock-like scars. Although 250 cases have been reported until now, the occurrence of disease in siblings is very rare. We report three familial cases of lipoid proteinosis involving a brother and sister and their nephew.

Anti-thyroid peroxidase antibody and vitiligo: a controlled study.

BACKGROUND: Vitiligo is an acquired depigmenting disorder due to destruction of melanocytes. Although many theories have been suggested for its pathogenesis, the role of autoimmunity is the most popular one. The association of vitiligo with autoimmune thyroid diseases and the increased prevalence of autoantibodies including thyroid autoantibodies in vitiligo favor this role. Our objective was to compare the frequency of thyroid peroxidase antibody (anti-TPO) in vitiligo patients with healthy subjects in Iran. METHODS: Ninety-four cases of vitiligo (46 female and 48 male) and 96 control subjects (49 female and 47 male) were enrolled in this controlled study. Patients with known thyroid disease, history of thyroid surgery and those receiving thyroid medications were not included. The two groups were matched regarding gender and age. The demographic data, symptoms related to thyroid diseases and results of skin and thyroid examinations were recorded in a questionnaire for each subject. Thyroid function tests including free T3, free T4 and TSH-IRMA were performed. Anti-TPO levels were assessed as well. The collected data were analyzed by SPSS version-11 in vitiligo patients and subgroups according to gender, age, extent, and duration of the disease compared with the control group. RESULTS: Anti-TPO was detected in 17 (18.1%) of patients affected by vitiligo, while this figure was 7 (7.3%) in the control group; the difference was significant with p-value < 0.025 (Phi & Cramer's V = 0.162). When analyzing subgroups, the difference in the frequency of anti-TPO remained significant only in females (p-value < 0.044) (Phi & Cramer's V = 0.207) and in patients in the age ranges of 18-25 (p-value < 0.05) (Phi & Cramer's V = 0.28) and 26-35 year-old (p-value < 0.042) (Phi & Cramer's V = 0.304). The difference of the frequency of anti-TPO was not significant regarding the duration and extent of vitiligo. In addition, there was no significant difference in the levels of free T3, free T4, and TSH in vitiligo patients compared with the control group. CONCLUSION: According to our study, anti-TPO was shown to be significantly more common in vitiligo patients especially in young women, compared with control group. As this antibody is a relatively sensitive and specific marker of autoimmune thyroid disorders including Hashimoto thyroiditis and Graves' disease, and considering the fact that vitiligo usually precedes the onset of thyroid dysfunction, periodic follow-up of vitiligo patients for detecting thyroid diseases is further emphasized especially in young women with increased level of anti-TPO.