Alterations in hypothalamic-pituitary axis (HPA) hormones 6 months after cranial radiotherapy in adult patients with primary brain tumors outside the HPA region.

BACKGROUND: Cranial radiotherapy is a common treatment for brain tumors, but it can affect the hypothalamic-pituitary (H-P) axis and lead to hormonal disorders. This study aimed to compare serum levels of HPA hormones before and after cranial radiation. MATERIALS AND METHODS: This study involved 27 adult patients who underwent brain tumor resection before the initiation of radiotherapy, and none had metastatic brain tumors. All participants had the HPA within the radiation field, and their tumors were located in brain areas outside from the HPA. Serum levels of HPA hormones were recorded both before and 6 months after cranial radiotherapy. RESULTS: A total of 27 adult patients, comprising 16 (59.3%) males and 11 (40.7%) females, with a mean age of 56.37 ± 11.38 years, were subjected to evaluation. Six months post-radiotherapy, serum levels of GH and TSH exhibited a significant decrease. Prior to radiotherapy, a substantial and direct correlation was observed between TSH and FSH (p = 0.005) as well as LH (p = 0.014). Additionally, a significant and direct relationship was noted between serum FSH and LH (p < 0.001) before radiotherapy. After radiotherapy, a significant and direct correlation persisted between TSH and FSH (p = 0.003) as well as LH (p = 0.005), along with a significant and direct relationship between serum FSH and LH (p < 0.001). Furthermore, a significant and direct association was identified between changes in serum GH levels and FSH (p = 0.04), as well as between serum LH and FSH (p < 0.001). CONCLUSION: Reduced serum levels of HPA hormones are a significant complication of cranial radiotherapy and should be evaluated in follow-up assessments.

Diagnostic accuracy of tumor M2-pyruvate kinase (tM2-PK) as a non-invasive biomarker in colorectal cancer: A systematic review and meta-analysis.

INTRODUCTION: The tumor pyruvate kinase M2 isoform (tM2-PK) is a glycolytic enzyme isoform that is present on the surface of rapidly proliferating cancer cells. The objective of this investigation was to assess the efficacy of the tM2-PK measurement assay in detecting colorectal cancer (CRC) through the analysis of serum/plasma and stool samples obtained from patients. METHODS: The pooled diagnostic performance measures, including sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), the area under the curve (AUC), Q*index, and summary receiver-operating characteristic curve (SROC), were computed using the Meta-Disc V.1.4 and Comprehensive Meta-Analysis V.3.3 software. The statistical methods of I2 and chi-square were employed to assess the presence of heterogeneity. The estimation of publication bias was conducted through the implementation of Begg's rank correlation and Egger's regression asymmetry tests. RESULTS: A total of 28 studies were found, involving 2900 participants (1560 cases and 1340 controls). The diagnostic accuracy of tM2-PK was calculated in CRC based on the pooled sensitivity of 83.70% (95% CI: 82.0% - 85.30%), specificity of 74.0% (95% CI: 72.0% - 76.0%), PLR of 4.432 (95% CI: 3.33 - 5.60), NLR of 0.187 (95% CI: 0.144 - 0.243), DOR of 30.182 (95% CI: 19.761 - 46.10) as well as AUC at 91.6%, and Q*-index at 85.0%. Publication bias was seen based on Begg's (p = 0.0006) and Egger's (p = 0.00015) tests. CONCLUSION: The results demonstrate that tM2-PK exhibits promise as a fair marker for CTRC, with the potential to serve as a non-invasive biomarker.

Detection of Circulating Cell-Free DNA to Diagnose Hepatocellular Carcinoma in Chinese Population: A Systematic Review and Meta-Analysis.

BACKGROUND: Cell-free circulating DNA has been known for many years, but this knowledge has not been beneficial for diagnosis. In this meta-analysis, we examine the diagnostic role of circulating cell-free DNA in HCC patients to find a reliable biomarker for the early detection of HCC. MATERIALS AND METHODS: We performed a systematic literature search using Science Direct, Web of Science, PubMed/Medline, Scopus, Google Scholar, and Embase, up to April 1st, 2022. Meta-Disc V.1.4 and Comprehensive Meta-Analysis V.3.3 software calculated the pooled specificity, sensitivity, area under the curve (AUC), diagnostic odds ratio (DOR), positive likelihood ratio (PLR), negative likelihood ratio (NLR) Q*index, and summary receiver-operating characteristic (SROC) for the role of cfDNA as a biomarker for HCC patients. Moreover, the subgroup analyses have been performed based on sample types (serum/plasma) and detection methods (MS-PCR/methylation). RESULTS: A total of 7 articles (9 studies) included 697 participants (485 cases and 212 controls). The overall pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) were 0.706 (95% CI: 0.671 - 0.739), 0.905 (95% CI: 0.865 - 0.937), 6.66 (95% CI: 4.36 - 10.18), 0.287 (95% CI: 0.185 - 0.445), 28.40 (95% CI: 13.01 - 62.0), and 0.93, respectively. We conducted a subgroup analysis of diagnostic value, which showed that the plasma sample had a better diagnostic value compared to the serum. CONCLUSION: This meta-analysis showed that cfDNA could be a fair biomarker for diagnosing HCC patients.

Blood-based microRNAs as Potential Diagnostic biomarkers for Melanoma: A Meta-analysis.

INTRODUCTION: Circulating microRNAs (miRNAs) serve as noninvasive diagnostic markers in many cancers. This meta-analysis aims to evaluate the diagnostic efficacy of circulating microRNAs for melanoma. MATERIAL AND METHODS: The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and ROC curve were evaluated using the Meta-Disc V.1.4 and Comprehensive Meta-Analysis V.3.3 software packages. To investigate the heterogeneity, the I2 and Chi-square tests were used. The publishing bias was evaluated using Begg's rank correlation and Egger regression asymmetry tests. RESULTS: A total of 9 articles covering 13 studies (more than 50 miRs individually and in combination) were included, containing 1,355 participants (878 cases and 477 controls). The overall pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio (DOR), and AUC were 0.78 (95% CI: 0.76-0.81), 0.80 (95% CI: 0.77-0.83), 4.32 (95% CI: 3.21-5.82), 0.17 (95% CI: 0.09-0.32), 28.0 (95% CI: 15.34-51.09), and 0.91, respectively. According to Begg's and Egger's tests, there was no publication bias (Begg's p = 0.160 and Egger's p = 0.289). CONCLUSION: Circulating miRNAs can serve as fair and non-invasive diagnostic biomarkers for melanoma. Additionally, specific miRNAs still need to be discovered for diagnosing melanoma.

The clinical relationship between histamine-1 receptor antagonists and risk of cancer: a systematic review and meta-analysis.

BACKGROUND: A systematic research was performed to review the relationship between use of histamine-1 receptor antagonists and cancer risk. METHOD: Databases were searched up to December 2021. Case-control and cohort studies evaluating the relationship between use of histamine-1 receptor antagonists and risk of cancer were selected. The major outcome was cancer risk. Odds ratio (OR) with 95% confidence intervals (CIs) was calculated. Subgroup, cumulative, and sensitivity analysis and Egger test were performed. RESULTS: Five case-controls and one cohort study were included. According to cohort study, use of antihistamines were not associated with cancer risk (RR = 0.92, 95% CI = (0.78-1.07). In case-controls, the frequency of antihistamine use in cases and controls was 11.28% and 14.82% respectively which was associated with decreased cancer risk (p value = 0.02, OR = 0.93, 95%CI = (0.87, 0.99)). Sensitivity analysis showed a change in direction of pooled OR by omitting some studies. Sub-group analysis according to type of cancer showed a decrease in cancer risk in antihistamine users in glioma (p value = 0.03). CONCLUSION: Antihistamines might reduce the risk of certain cancers. More studies with defined background of allergy are needed which can clarify the relevancy of different types of cancer with anti-H1 receptors.

Can microRNAs be utilized as tumor markers for recurrence following nephrectomy in renal cell carcinoma patients? A meta-analysis provides the answer.

INTRODUCTION: Renal cell carcinoma (RCC) is an aggressive tumor. Many studies investigated microRNAs (miRs) as RCC prognostic biomarkers, often reporting inconsistent findings. We present a meta-analysis to identify if tissue-derived miRs can be used as a prognostic factor in patients after nephrectomy. METHODS: Data were obtained from PubMed, Embase, and Web of Science. The hazard ratio with 95% confidence intervals assessed the prognostic value of microRNAs. Outcomes of interest included the prognosis role of microRNAs in overall survival (OS), recurrence-free survival (RFS), and cancer-specific survival (CSS) in nephrectomy patients. RESULTS: Nine retrospective studies that evaluated microRNAs in 1,541 nephrectomy patients were collected. There were heterogeneities across studies for microRNAs in the 15 studies examining OS, RFS, and CSS (I2 = 84.51%; P < 0.01); the random-effect model was calculated (HR = 1.371; (95% CI: 0.831-2.260); P = 0.216). CONCLUSION: Our study indicated that miRNAs cannot be used as a marker for recurrence in RCC patients after nephrectomy, and researchers shouldn't make the mistake that if miRs can be used as a biomarker in RCC, they cannot be used as a marker after nephrectomy in RCC. As all of these findings were from retrospective studies, further studies are needed to verify the role of microRNAs in clinical trials.

Clinicopathological utility of miR-203a-3p in diagnosing colorectal cancer.

BACKGROUND: Biomarkers, such as microRNAs, are helpful in diagnosing colorectal cancer, regulating disease progression, predicting disease recurrence, and determining therapy success. This research aimed to look at the clinicopathological characteristics of serum miRNA-203a-3p expression in colorectal cancer patients. METHODS AND RESULTS: This case-control study was conducted on 43 patients with colorectal cancer and 43 healthy individuals. After RNA extraction, cDNA was synthesized. The expression of miR-203a-3p was measured using RT-qPCR. Demographic and histochemical data were extracted from patient documents. SPSS and GraphPad Prism software were used to analyze the data. The expression of miR-203a-3p in CRC patients was 2.39 times lower than in the control group (p < 0.0001). The miR-203a-3p expression was significantly lower in the CRC tumor stages, tumor grades, and lymph node metastasis compared to the control group (p < 0.0001 each). The ROC curves showed that the AUC was 0.73, and the best cut-point based on the Youden index was 0.3954, 0.7105, 0.5087, and 0.4868 for detecting colorectal cancer (p = 0.0002), tumor grade (p = 0.006), tumor stage (p = 0.001), and lymph node metastasis (p = 0.0011) compared to the control group, respectively. The binary logistic regression analysis was performed on the correlation between BMI, smoking, and cancer inheritance with miR-203a-3p in cancer and control groups. CONCLUSION: This study's findings revealed that serum miR-203a-3p is a fair non-invasive molecular biomarker for diagnosing and progressing tumor grade, tumor stage, and lymph node metastasis in colorectal cancer. However, further research with higher statistical numbers is needed to strengthen the correlation and be used for diagnostic applications.

Brain tumors and circulating micrornas: a systematic review and diagnostic meta-analysis.

PURPOSE: Brain tumors (BT) are among the most prevalent cancers in recent years. Various studies have examined the diagnostic role of microRNAs in different diseases; however, their diagnostic role in BT has not been comprehensively investigated. This meta-analysis was performed to assess microRNAs in the blood of patients with BTs accurately. METHODS: Twenty-six eligible studies were included for analysis. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), area under curve (AUC), Q*index, summary receiver-operating characteristic (SROC) were assessed using the Meta-Disc V.1.4 and Comprehensive Meta-Analysis V.3.3 software. RESULTS: The diagnostic accuracy of microRNA was high in identifying BT based on the pooled sensitivity 0.82 (95%CI: 0.816-0.84), specificity 0.82 (95%CI: 0.817-0.84), PLR 5.101 (95%CI: 3.99-6.51), NLR 0.187 (95%CI: 0.149-0.236), DOR 34.07 (95%CI: 22.56-51.43) as well as AUC (0.92), and Q*-index (0.86). Subgroup analyses were performed for sample types (serum/plasma), reference genes (RNU6, miR-39, and miR-24), and region to determine the diagnostic power of microRNAs in the diagnosis of BT using pooled sensitivity, specificity, PLR, NLR, AUC, and DOR. CONCLUSION: This meta-analysis suggested that circulating microRNAs might be potential markers for noninvasive early detection of BT.

Osteolysis: A Literature Review of Basic Science and Potential Computer-Based Image Processing Detection Methods.

Osteolysis is one of the most prominent reasons of revision surgeries in total joint arthroplasty. This biological phenomenon is induced by wear particles and corrosion products that stimulate inflammatory biological response of surrounding tissues. The eventual responses of osteolysis are the activation of macrophages leading to bone resorption and prosthesis failure. Various factors are involved in the initiation of osteolysis from biological issues, design, material specifications, and model of the prosthesis to the health condition of the patient. Nevertheless, the factors leading to osteolysis are sometimes preventable. Changes in implant design and polyethylene manufacturing are striving to improve overall wear. Osteolysis is clinically asymptomatic and can be diagnosed and analyzed during follow-up sessions through various imaging modalities and methods, such as serial radiographic, CT scan, MRI, and image processing-based methods, especially with the use of artificial neural network algorithms. Deep learning algorithms with a variety of neural network structures such as CNN, U-Net, and Seg-UNet have proved to be efficient algorithms for medical image processing specifically in the field of orthopedics for the detection and segmentation of tumors. These deep learning algorithms can effectively detect and analyze osteolytic lesions well in advance during follow-up sessions in order to administer proper treatments before reaching a critical point. Osteolysis can be treated surgically or nonsurgically with medications. However, revision surgeries are the only solution for the progressive osteolysis. In this literature review, the underlying causes, mechanisms, and treatments of osteolysis are discussed with the main focus on the possible computer-based methods and algorithms that can be effectively employed for the detection of osteolysis.

Epidermal growth factor receptor inhibitor in advanced basal cell carcinoma.

Cetuximab can be used for the treatment of advanced basal cell carcinoma, especially when the patient cannot tolerate routine chemotherapy. Future studies are needed to confirm it.

Lung Infection Segmentation for COVID-19 Pneumonia Based on a Cascade Convolutional Network from CT Images.

The COVID-19 pandemic is a global, national, and local public health concern which has caused a significant outbreak in all countries and regions for both males and females around the world. Automated detection of lung infections and their boundaries from medical images offers a great potential to augment the patient treatment healthcare strategies for tackling COVID-19 and its impacts. Detecting this disease from lung CT scan images is perhaps one of the fastest ways to diagnose patients. However, finding the presence of infected tissues and segment them from CT slices faces numerous challenges, including similar adjacent tissues, vague boundary, and erratic infections. To eliminate these obstacles, we propose a two-route convolutional neural network (CNN) by extracting global and local features for detecting and classifying COVID-19 infection from CT images. Each pixel from the image is classified into the normal and infected tissues. For improving the classification accuracy, we used two different strategies including fuzzy c-means clustering and local directional pattern (LDN) encoding methods to represent the input image differently. This allows us to find more complex pattern from the image. To overcome the overfitting problems due to small samples, an augmentation approach is utilized. The results demonstrated that the proposed framework achieved precision 96%, recall 97%, F score, average surface distance (ASD) of 2.8 ± 0.3 mm, and volume overlap error (VOE) of 5.6 ± 1.2%.

Clinical Evaluation of the Diagnostic Role of MicroRNA-155 in Breast Cancer.

AIM: Biochemical markers, including microRNAs (miRs), may facilitate the diagnosis and prognosis of breast cancer. This study was aimed at assessing serum miR-155 expression in patients with breast cancer and receptors. METHODS: This case-control study was conducted on 36 patients with breast cancer and 36 healthy individuals. After RNA extraction from the patient's serum, cDNA was synthesized. The expression of miR-155 was measured using RT-qPCR. Demographic and histochemical data were extracted from patient documents. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software. RESULTS: The mean age of subjects in breast cancer and control groups was 47.64 ± 8.19 and 47.36 ± 7.52 years, respectively. The serum miR-155 expression was higher in the cancer group (1.68 ± 0.66) compared to the control group (p < 0.0001). There was a significant relationship between serum miR-155 expression and the tumor grade (p < 0.001), tumor stage (p < 0.001), and tumor size (p < 0.001) of the patients. However, no relationship between miR-155 expression and the presence of lymph node involvement (p = 0.15), HER2 (p = 0.79), Ki-67 (p = 0.9), progesterone receptor (p = 0.54), and estrogen receptors (p = 0.84) was found. The ROC curve analysis showed that the AUC was 0.89 (77.78% sensitivity and 88.89% specificity), and the cutoff was 1.4 (Youden index: 0.6667) for detecting breast cancer. CONCLUSION: The findings of this study revealed that serum miR-155 may serve as a potential noninvasive molecular biomarker for breast cancer diagnosis and can help predict the grade of the disease.

Glassy carbon electrode modified with hybrid nanofibers containing carbon nanotubes trapped in chitosan for the voltammetric sensing of nicotine at biological pH.

In this paper, nicotine (NIC) was detected by cyclic voltammetry (CV) using a modified glassy carbon (GC) electrode. To do this, the surface of the GC electrode was modified by hybrid nanofiber obtained from the electrospinning method. Hybrid nanofibers were produced through the dispersion of carboxylated multi-walled carbon nanotube (MWCNT-COOH) as an inorganic component in the chitosan (CS) polymer matrix as an organic component. The nanofibers showed unique morphology and high surface area value. With the increase of functionalized carbon nanotube content in the nanofibers, the mean pore diameter and average nanofiber diameter increased. The electrochemical properties of nanofibers towards the sensing of NIC were investigated by the CV method. NIC was irreversibly reduced with the use of a CS/MWCNT-COOH electrode, a controlled process with two protons and two electrons. An oxidation signal at lower potential with higher current was obtained for NIC with the use of a polymer-modified electrode compared to a GC electrode. This was as a result of the electrocatalytic effect of the hybrid nanofibers due to the ability of carbon nanotubes to increase the rate of electron transfer. Under optimum conditions, the oxidation of NIC occurred at 0.82 eV with a pH of 7.4. The linear calibration curve was in the concentration range of 0.1-100 µM NIC (R 2 = 0.9987) with a detection limit of 30 nM. For 100 parallel 10 µM NIC diagnoses for five replicates, 97.2% with a standard deviation of 4.08 maintained their stability over the first cycle. This indicates that the CS/MWCNT-COOH electrode has excellent reproducibility and stability.

Evaluation of the Diagnostic Properties of Serum hsa-miR-223-5p in the Detection of Gastric Cancer: A Case-Control Study.

BACKGROUND: MicroRNAs (miRs) are a group of small non-coding and single-stranded RNAs of 18 to 25 nucleotides. The study of microRNAs is one of the new ways to detect cancer. In this study, the serum expression of miR-223 in patients with GC was measured and compared with the control group. METHODS: This case-control study was conducted on 39 patients with GC and 39 control subjects who visited the Reza Radiotherapy and Oncology Center, Mashhad, Iran, due to gastrointestinal complaints. The demographic information was collected, and the serum levels of miR-223 were measured using the real-time PCR technique in all study subjects. The association between the GC of miR-223 and tumor staging and cancer progression was assessed. RESULTS: The miR-223 expression in GC patients was 3.10-fold higher than that of the control group (p<0.0001). The miR-223 expression was significantly higher in the GC stages and grades compared to the control group (p<0.0001 each). However, there was no significant effect for age, smoking, and gender on miR- 223 expression in GC and controls. At the optimal cutoff value of 0.7436, the maximal sensitivity of 89.74% and specificity of 84.62% were achieved for miR-223 (p<0.001). The sensitivity and specificity for miR-223 for differentiating low grades from high grade were 92.31% and 73.08% (p=0.0003), and for differentiating low stages from the high stage was 81.82% and 39.29% respectively (p=0.696). CONCLUSION: This study revealed that miR-223 could be considered as a non-invasive diagnostic marker in the early diagnosis of GC.

Dietary polyphenols for atherosclerosis: A comprehensive review and future perspectives.

Atherosclerosis is one of the most prevalent reasons for premature death in adults. Despite the several conventional drugs in the market; many patients are not completely treated. Here we comprehensively review current clinical evidence regarding the efficacy of dietary polyphenols in atherosclerosis and related complications. PubMed, Cochrane library and Scopus were searched from inception until August 2016 to obtain clinical trials in which polyphenols were evaluated in cardiovascular parameters related to atherosclerosis. From total of 13031 results, 49 clinical trials were finally included. Tyrosol derivatives from virgin olive oil, catechins and theaflavins from green and black tea, cocoa polyphenols, and red grape resveratrol, as well as anthocyanins were the most studied polyphenolic compounds which could regulate lipid profile, inflammation and oxidative stress, blood pressure, endothelial function, and cell adhesion molecules. The most important limitations of the included trials were small sample size, short follow up, and unqualified methodology. Future well-designed clinical trials are necessary to provide better level of evidence for clinical decision making.

Inflammatory myofibroblastic tumor of salpinx: a very rare case treated with a less aggressive method.

Inflammatory pseudotumour describes as a wide range of neoplastic and reactive lesions. One of the rare presentations of these tumors is found in the salpinx. This case report characterizes a thirty six year old woman with a history of left sided abdominal pain for a few months. Further examinations revealed that she had a complex cyst in her left salpinx. The patient had normal levels of tumor markers such as CA125, Alfa Fetoprotein (AFP), and Human Chorionic Gonadotropin (hCG), while other paraclinical test were in normal values Additionaly The patient underwent left salpingectomy by a gynecologist. The pathological diagnosis of the lesion was inflammatory myofibroblastic tumor (IMT). In immunohistochemistry the tumor stains was moderately positive in anaplastic lymphoma kinase (ALK) and also actin positive. Total resection of tumor was performed with no complications and remained disease free during follow up for 40 months. Although Inflammatory Myofibroblastic Tumor (IMT) is benign in nature, but in order to improve the prognosis, this tumor requires low intensity surgical treatment.

Coronary artery angiographic changes in veterans poisoned by mustard gas.

OBJECTIVES: We aimed to identify coronary artery involvement in mustard gas-poisoned patients. METHODS: We conducted a case-control study on 40 mustard gas-poisoned patients who underwent coronary artery angiography due to cardiac pain. The study was performed during a 3-year interval on patients who were referred to three main hospitals of Mashhad, Iran. The nonexposed control group consisted of 40 normal individuals who had undergone angiography for the same reasons. The primary outcome measurement was coronary artery involvement and its location. Data were collected through studying the angiography films. RESULTS: Among the 40 poisoned patients studied, 15 (37.5%) had coronary artery ectasia, mainly in the left anterior descending artery, but 25 (62.5%) did not. The same values were 2 (5%) and 38 (95%) in the nonexposed group, respectively, which was significantly different compared to the exposed group (p = 0.001). The odds ratio was 11.40. CONCLUSIONS: The prevalence of coronary artery ectasia in mustard gas-poisoned patients was 7.5 times more than in nonexposed controls. Considering the proposed odds ratio, the occurrence of coronary artery ectasia is around 11.4 times greater in mustard gas-poisoned veterans. This is the first study to suggest a strong correlation between mustard gas poisoning and coronary artery ectasia.