Safety and efficacy of fecal microbiota transplantation (FMT) as a modern adjuvant therapy in various diseases and disorders: a comprehensive literature review

The human gastrointestinal (GI) tract microbiome is a complex and all-encompassing ecological system of trillions of microorganisms. It plays a vital role in digestion, disease prevention, and overall health. When this delicate balance is disrupted, it can lead to various health issues. Fecal microbiota transplantation (FMT) is an emerging therapeutic intervention used as an adjuvant therapy for many diseases, particularly those with dysbiosis as their underlying cause. Its goal is to restore this balance by transferring fecal material from healthy donors to the recipients. FMT has an impressive reported cure rate between 80% and 90% and has become a favored treatment for many diseases. While FMT may have generally mild to moderate transient adverse effects, rare severe complications underscore the importance of rigorous donor screening and standardized administration. FMT has enormous potential as a practical therapeutic approach; however, additional research is required to further determine its potential for clinical utilization, as well as its safety and efficiency in different patient populations. This comprehensive literature review offers increased confidence in the safety and effectiveness of FMT for several diseases affecting the intestines and other systems, including diabetes, obesity, inflammatory and autoimmune illness, and other conditions

Investigation of the prevalence of latent tuberculosis in cancer patients compared to non-cancer patients: a case-control study

BackgroundLatent tuberculosis (TB) can reactivate in immunocompromised individuals, such as cancer patients undergoing chemotherapy, leading to severe complications. Understanding the prevalence of latent TB in this high-risk group is crucial, especially in regions with moderate to high TB burdens.AimThis study aims to determine the prevalence of latent tuberculosis in cancer patients before chemotherapy and immunotherapy to guide preventive interventions and reduce the risk of TB reactivation.MethodsThis case-control study was conducted at Sina Hospital in Tehran, Iran, from 2012 to 2022. A total of 392, including 107 newly diagnosed cancer (case) and 285 non-cancer (control) patients, were enrolled in this study. All patients had received the Bacillus Calmette-Guérin (BCG) vaccine at the age of one. They underwent a thorough clinical examination and were screened using the tuberculin skin test (TST) to detect latent TB. Any active TB cases were identified through acid-fast smear tests. The data collected from the study participants was then analyzed.ResultsThe results showed no significant difference in the size of TST between cancer and non-cancer patients (cases: median = 2 mm, IQR: 1–12; controls: median = 2 mm, IQR: 1–5; p = 0.09). The prevalence of latent TB was 27.1% in cancer patients and 20.7% in non-cancer patients, with no significant association identified between latent TB and malignancies (P-value = 0.176). Over a median follow-up of 4 years, mortality was significantly higher in cancer patients compared to controls (42.1% vs 1.8%; P< 0.001, OR = 40.64). Additionally, deceased patients exhibited a greater prevalence of latent TB (44% vs 19.3% in survivors; P< 0.001, OR = 3.28), and increased size of TST was associated with higher mortality risk among cancer patients.ConclusionIn conclusion, this study emphasizes the need for vigilant latent TB screening in cancer patients, given the association between larger TST sizes and increased mortality risk. While no direct link between cancer type and latent TB was found, proactive TB management remains crucial, particularly for those undergoing immunosuppressive therapy

Efficacy of Direct Acting Antivirals (DAA) therapy in patients with recurrent hepatitis C after liver and kidney transplantation: a cross-sectional study

Background and objectivesDirect-acting antiviral (DAA) agents are now widely used to treat patients with hepatitis C infection (HCV) and effectively increase their sustained virologic response (SVR). However, the literature seems to lack or deficient evidence of DAA efficacy in more complicated patients, especially those with HCV reinfection after liver transplantation (LT) or liver-kidney (hepatorenal) transplantation (LKT). This study aimed to retrospectively evaluate the effectiveness of two different DAA regimens in LT and LKT patients with HCV reinfection.MethodsThis cross-sectional study was conducted at three hospitals in Tehran, Iran, from 2014 to 2020, enrolling 53 patients with recurrent HCV infection after LT (n = 35) or LKT (n = 18). Patients were treated for 12 weeks with one of two DAA regimens: 37 patients (70%) received Daclatasvir and Sofosbuvir (SOF + DCV), while 16 patients (30%) received Sofosbuvir and Ledipasvir (SOF + LDV). Ribavirin (RBV) was added as an adjunct antiviral in 28 patients (52.8%). To assess the SVR, all patients were followed for 12 weeks after treatment.ResultsBoth DAA regimens were well-tolerated and effective, with 94.6% (35 of 37) achieving SVR-12 in the SOF + DCV group and 93.8% (15 of 16) in the SOF + LDV group. Additionally, SVR-12 rates were promising across treatment durations, with 93.9% (31 of 33) in the 12-week group and 95% (19 of 20) in the 24-week group achieving undetectable HCV RNA. No significant difference in SVR was observed between the two regimens (p = 0.439).ConclusionThe DAA-based therapeutic regimen was well tolerated and showed significant effectiveness in achieving the virologic response in patients with HCV reinfection after LT or LKT

Evaluation of overall survival and disease-free survival of adjuvant chemotherapy and hormone therapy in patients with breast cancer

Abstract : Background: This study evaluated the effect of adjuvant chemotherapy and hormone therapy on overall survival and disease-free survival in patients with breast cancer with hormone receptor-positive, HER2-negative tumor without lymph node involvement. Methods: Breast cancer patients with hormone receptor-positive, HER2-negative, and no lymph node involvement were included in this retrospective cohort study. Patient records were used to collect data on sex, age, time of disease onset, tumor subtype, tumor size, grade, lymphovascular and perineural involvement, ki67, and treatment protocols. Patients were divided into 2 groups: Patients who received both adjuvant chemotherapy and hormonal therapy and patients who received hormonal therapy only. Disease-free survival index (DFS) and overall survival index (OS) were evaluated. Results: Sixty-seven female patients were enrolled in this study. Of them, 68.2% received both adjuvant chemotherapy and hormonal therapy and 31.6% received hormonal therapy only. During follow-up, recurrences occurred in 8 patients. The 3-year and 5-year DFS were 93.4% and 90%, respectively. The 3-year and 5-year DFS were 94% and 92%, respectively, in patients who received both adjuvant chemotherapy and hormonal therapy, and 91% and 85%, respectively, in patients who received hormonal therapy. None of the factors studied affected the 3-year and 5-year DFS. The 3-year and 5-year DFS OS were 98.6% and 96.9%, respectively CONCLUSION: Adjuvant chemotherapy in patients with breast cancer with hormone receptor-positive, HER2-negative, and no lymph node involvement compared with similar patients receiving hormone therapy alone had no significant difference in disease-free survival index and overall survival index. Keywords: breast cancer; disease-free survival index; overall survival inde

Peripheral T-cell Lymphoma of the oral cavity: a case report

In this article, we report a 34-year-old man who presented with a buccal progressive ulcerated lesion which through histopathologic and IHC findings diagnosed as Peripheral T-cell lymphoma.</jats:p

Primary diffuse large B-cell lymphoma of the bone mimicking osteomyelitis

In this article, we report a 34-year-old man who presented with progressive hip pain and osteolytic bone lesions . Primary workup included Core needle biopsies manifested as osteomyelitis; however as no sign of remission was observed, an open biopsy considered which revealed primary bone lymphoma.</jats:p