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A Survey on Gastrointestinal Stromal Tumors (GISTs) Incidence in Iran: a National Population-based cancer registry Study.
No full textBackground: Gastrointestinal stromal tumors (GISTs) are rare neoplasms of the gastrointestinal (GI) tract which are associated with high rates of malignant transformation. The current study aims to design a survey to assess the incidence of GISTs in Iran through a multicenter population-based cancer registry study. Materials and Methods: A total of 447 GISTs patients who have been registered to Iran National Cancer Registry (INCR) between 2009 to 2014 were ordered into age strata, based on WHO guidelines. Patients were categorized into six groups by region. Tumors were classified into GI and extra GI tumors. Also, grading of tumors performed according to the International Classification of Diseases for Oncology, 3rd Revision (ICD-O). Crude incidence rate, age-standardized incidence rate (ASIR), and sex standardized incidence rate (SSIR) were calculated by using SPSS software. Results: In the current study all 447 cases of GISTs that were registered between 2009 to 2014 were included. 56.5 of them (253/447) were male, with a male to female ratio of 1.3:1. The majority of patients were found in Isfahan (17.8). 68.6 (307/447) of cases aged between 15 and 64, with the most involved age stratum being 50-55 years old (14.5). Crude incidence rate was 5.948 per 1,000,000 and age standard incidence rate (ASIR) was 7.334 per 1,000,000. The highest ASIR was 1.593 per 1,000,000 in 2012 and then it declined. The stomach was the leading location of tumors (46), followed by the small intestine (23). Conclusions The occurrence of GISTs is more common in men and the older population. As a preliminary National Population study, the rate of GISTs in the Iranian population has been declined over the study period. © 2021 Ioannina University School of Medicine. All rights reserved
Infectious keratitis: trends in microbiological and antibiotic sensitivity patterns
No full textObjectives: To report the spectrum and trends of isolated microorganisms and their antibiotic susceptibility profile in patients with infectious keratitis in a 6-year period at a referral centre in Tehran. Methods: The microbiology records of all corneal scrapings with a diagnosis of infectious keratitis were reviewed. Results: A total of 6282 corneal scrapings were performed during the study period, of which 2479 (39.5) samples were culture positive. Pseudomonas aeruginosa was found to be the most common causative agent in patients with keratitis, although Streptococcus pneumonia was the most prevalently isolated microorganism in patients older than 50 years. Fusarium sp. was the most common responsible pathogen in patients with fungal keratitis. The prevalence of bacterial keratitis due to gram positive microorganisms increased over time, however the number of Pseudomonas keratitis decreased in the second half of the study. Gram negative organisms showed a good sensitivity to levofloxacin, however, 34.1 of S. aureus isolates and 29.7 of coagulase negative staphylococci were resistant to this antibiotic. The odds of ciprofloxacin and levofloxacin resistance increased 1.25 and 1.15 for each 1-year increase in culture date, respectively (P < 0.001, P = 0.004). Conclusions: We documented an increasing trend in the percentage of gram positive bacteria. Levofloxacin monotherapy might still be a good option in patients with gram negative bacterial keratitis, however owing to increasing resistance of staphylococci to fluoroquinolones, a regimen consisting of a combination of fortified antibiotics may be more effective in staphylococcal keratitis. © 2021, The Author(s), under exclusive licence to The Royal College of Ophthalmologists
Gastric pull-up with laryngeal preservation of the primary synovial sarcoma of the esophagus: A case report
Full text linkIn patients who require a gastric pull-up, despite bilateral injury to the vocal cords and regurgitation, preservation of the larynx can improve their quality of life. © 2021 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd
Irreversible coronary aneurysm presenting as acute coronary syndrome in a child with hypereosinophilic syndrome: A case report
No full textHypereosinophilic syndrome is defined as persistent eosinophilia in the blood for more than 6 months, without any identifiable cause and with end-organ involvement evidence. Cardiac manifestations of HES include heart failure due to restrictive cardiomyopathy, arrhythmia, intraventricular thrombosis, and coronary artery involvement occurs frequently. In rare instances, coronary ectasia, aneurysms, or dissection can occur and cause morbidity and mortality in these patients. A coronary aneurysm occurs rarely in adult patients with HES but to our knowledge, this is the first report of this association in a 14-year-old boy who was presented to us as coronary aneurysm due to hypereosinophilic syndrome. © The Author(s), 2021. Published by Cambridge University Press
Opsoclonus-myoclonus syndrome, a post-infectious neurologic complication of COVID-19: case series and review of literature
Full text linkOpsoclonus-myoclonus-ataxia syndrome is a heterogeneous constellation of symptoms ranging from full combination of these three neurological findings to varying degrees of isolated individual sign. Since the emergence of coronavirus disease 2019 (COVID-19), neurological symptoms, syndromes, and complications associated with this multi-organ viral infection have been reported and the various aspects of neurological involvement are increasingly uncovered. As a neuro-inflammatory disorder, one would expect to observe opsoclonus-myoclonus syndrome after a prevalent viral infection in a pandemic scale, as it has been the case for many other neuro-inflammatory syndromes. We report seven cases of opsoclonus-myoclonus syndrome presumably parainfectious in nature and discuss their phenomenology, their possible pathophysiological relationship to COVID-19, and diagnostic and treatment strategy in each case. Finally, we review the relevant data in the literature regarding the opsoclonus-myoclonus syndrome and possible similar cases associated with COVID-19 and its diagnostic importance for clinicians in various fields of medicine encountering COVID-19 patients and its complications. © 2021, Journal of NeuroVirology, Inc
Prevalence and genotype distribution of human papillomavirus infection in different anatomical sites among men who have sex with men: A systematic review and meta-analysis
No full textMen who have sex with men (MSM) are at increased risk of human papillomavirus (HPV) infection because of their high-risk sexual behaviours. In this study, a meta-analytic approach was used to systematically analyse the literature to elucidate the prevalence and genotype distribution of anal, penile, oral and urethral HPV infection among MSM in the world. To carry out this systematic review, five electronic databases including Web of Science, PubMed, Scopus, Embase, and Google Scholar were searched for relevant studies published from January 2012 to November 2019, and pertinent data were collected from the eligible articles. The pooled HPV prevalence was calculated for each anatomical region using a random-effect model weighted by the inverse variance method. The meta-analysis was performed using the �Metaprop� function in the R package Meta. The overall pooled prevalence of anal, penile, oral and urethral HPV infection among MSM were 78.4 (95 confidence interval CI: 75.6%�81.0%), 36.2% (95% CI: 29.1%�44.0%), 17.3% (95% CI: 13.6%�21.7%) and 15.4% (95% CI: 7.8%�27.9%), respectively. Stratified analyses showed that the prevalences of HPV were significantly higher in HIV-positive than HIV-negative MSM. The most frequent HPV high-risk type detected in the anus, penis and oral cavity was HPV-16 (19.9%, 4.9% and 3.1%, respectively). HPV infection is rising in MSM because of high-risk sexual behaviours, suggesting an increased future risk of developing HPV-related diseases and malignancies in this population. © 2021 John Wiley & Sons Ltd
Cause-specific hazard regression estimation for modified Weibull distribution under a class of non-informative priors
No full textIn time to event analysis, the situation of competing risks arises when the individual (or subject) may experience p mutually exclusive causes of death (failure), where cause-specific hazard function is of great importance in this framework. For instance, in malignancy-related death, colorectal cancer is one of the leading causes of the death in the world and death due to other causes considered as competing causes. We include prognostic variables in the model through parametric Cox proportional hazards model. Mostly, in literature exponential, Weibull, etc. distributions have been used for parametric modelling of cause-specific hazard function but they are incapable to accommodate non-monotone failure rate. Therefore, in this article, we consider a modified Weibull distribution which is capable to model survival data with non-monotonic behaviour of hazard rate. For estimating the cumulative cause-specific hazard function, we utilized maximum likelihood and Bayesian methods. A class of non-informative types of prior (uniform, Jeffrey�s and half-t) is introduced for Bayes estimation under squared error (symmetric) as well as LINEX (asymmetric) loss functions. A simulation study is performed for a comprehensive comparison of Bayes and maximum likelihood estimators of cumulative cause-specific hazard function. Real data on colorectal cancer is used to demonstrate the proposed model. © 2021 Informa UK Limited, trading as Taylor & Francis Group
A meta-analysis on association between viral infections and Kawasaki disease in children
No full textAim: To investigate the association between different viral infections and the development of Kawasaki disease (KD) in children. Materials & methods: Electronic databases were searched for relevant studies published from inception to May 2020. The pooled odds ratios (ORs) of the association of different viral pathogens with KD were estimated using a random-effects model weighted by the inverse variance method. Results: The strongest associations were found between KD and human parvovirus B19 viremia (OR = 41.05; 95 CI: 5.13-328.28; I-square = 0), EBV IgM seropositivity (OR = 7.18; 95 CI: 3.65-14.12, I-square = 0) and human herpesvirus-6 IgG seropositivity (OR = 5.83; 95 CI: 1.06-32.01). Conclusion: Human parvovirus B19, EBV and human herpesvirus-6 are highly suspected to be key contributors to the development of KD. © 2021 Future Medicine Ltd
Monitoring of the choline/lipid ratio by 1H-MRS can be helpful for prediction and early detection of tumor response to nano-photo-thermal therapy
No full textNanotechnology-based photothermal therapy (NPTT) is a new emerging modality of cancer therapy. To have the right prediction and early detection of response to NPTT, it is necessary to get rapid feedback from a tumor treated by NPTT procedure and stay informed of what happens in the tumor site. We performed this study to find if proton magnetic resonance spectroscopy (1H-MRS) can be well responsive to such an imperative requirement. We considered various treatment groups including gold nanoparticles (AuNPs), laser, and the combination of AuNPs and laser (NPTT group). Therapeutic effects on CT26 colon tumor-bearing BALB/c mice were studied by looking at alterations that happened in 1H-MRS signals and tumor size after conducting treatment procedures. In MRS studies, the alterations of choline and lipid concentrations and their ratio were investigated. Having normalized the metabolite peak to water peak, we found a significant decrease in choline concentration post-NPTT (from (1.25 ± 0.05) � 10�3 to (0.43 ± 0.04) � 10�3), while the level of lipid concentration in the tumor was slightly increased (from (2.91 ± 0.23) � 10�3 to (3.52 ± 0.31) � 10�3). As a result, the choline/lipid ratio was significantly decreased post-NPTT (from 0.41 ± 0.11 to 0.11 ± 0.02). Such alterations appeared just 1 day after NPTT. Tumor shrinkage in all groups was studied and significant changes were significantly detectable on day 7 post-NPTT procedure. In conclusion, the study of choline/lipid ratio using 1H-MRS may help us estimate what happens in a tumor treated by the NPTT method. Such an in vivo assessment is interestingly feasible as soon as just 1 day post-NPTT. This would undoubtedly help the oncologists make a more precise decision about treatment planning strategies. Graphical abstract: Figure not available: see fulltext.. © 2021, The Author(s), under exclusive licence to Springer-Verlag London Ltd. part of Springer Nature
Design, synthesis, and preliminary pharmacological evaluation of novel thiazolidinone derivatives as potential benzodiazepine agonists
No full textAbstract: Thiazolidinones are well-known heterocycles that demonstrate promising biological effects such as anticonvulsant activity. Hybridization of these chemicals with scaffold, which has necessary pharmacophores for binding to the benzodiazepine receptors, can prompt a novel structure possessing extensive anticonvulsant effects. In this study, novel derivatives of thiazolidinone as new benzodiazepine agonists were designed, synthesized, and biologically evaluated. Compound 5h, 4-chloro-2-(2-fluorophenoxy)-N-(4-oxo-2-(p-tolyl)thiazolidin-3-yl)benzamide, exhibited considerable anticonvulsant activity, proper sedative�hypnotic effect, no memory impairment, and no muscle relaxant effect. The pharmacological effects of the designed compounds were antagonized by flumazenil, which confirmed the benzodiazepine receptors� involvement in their biological effects. Based on in silico calculations of ADME properties of our novel compounds, they could be active oral agents potentially. Graphic abstract: In this study, we designed novel structures by the hybridization of thiazolidinone moiety with scaffold which has necessary pharmacophores for binding to the benzodiazepine receptors. The results are very promising for developing new lead compounds as benzodiazepine agonists possess anticonvulsant effects.Figure not available: see fulltext.. © 2021, The Author(s), under exclusive licence to Springer Nature Switzerland AG part of Springer Nature