Polyserositis (Concato's disease) due to granulocyte colony stimulating factor therapy for lymphoma

Polyserositis is defined as general inflammation of serous membranes associated with serous effusion due to many causes. In this study, we evaluated polyserositis as a rare complication of GCSF therapy. A 26-year-old man with a history of lymphoma was referred to our hospital complaining of dyspnea, tachycardia, tachypnea, chest pain, bilateral pleural effusion, ascites and massive pericardial effusion after 5 days of treatment with GCSF. After 7 days of treatment with indomethacin, dexamethasone and discontinuation of GCSF, the patient improved and was referred to an oncologist for chemotherapy of lymphoma. Based on this case report, we should consider various causes of pleural effusion in a patient with lymphoma, and use drugs with caution in such patients as they may be predisposed to dyspnea and fluid retention. ©2009 NRITLD, National Research Institute of Tuberculosis and Lung Disease

Long-term pulmonary functional status following coronary artery bypass grafting surgery

BACKGROUND: The present study aimed to describe the long-term alterations of pulmonary function and also to describe its association with post-operative pain after coronary artery bypass grafting (CABG) surgery. METHODS: In this prospective study, thirty non-smoker male patients undergoing isolated on-pump CABG were consecutively included in this study. Pulmonary function measurements were performed, in a sitting position, preoperatively, a week postoperatively, and 6 months after the surgery using a Medical Graphics PF/Dx pulmonary function system. Pain was determined by using visual analog scale (VAS) pain scores with a standardized questionnaire's. RESULTS: Regarding functional class, all patients had New York Heart Association (NYHA) Class II to III. A week after operation, a severe restrictive pulmonary impairment was revealed with a mean decrease in VC to 60.9 +/- 9.2% and in forced expiratory volume in one second (FEV1) to 64.6 +/- 12.2% of pre-operative values (P < 0.001). Regarding sternotomy related pain, the mean pain VAS score was preoperatively 3.3 +/- 1.5 that reached to 6.2 +/- 2.5 and 4.8 +/- 2.2 1 week and 6 months after the operation (P < 0.001). The trend of the changes in pain score within 6 months of operation was significantly similar to the trend of the changes in some pulmonary function indices such as FEV% and residual volume (RV). CONCLUSION: A significant reduction is expected in most pulmonary functional parameters following CABG despite normal pulmonary function state preoperatively. Severe pain originated from sternotomy may be an important factor related to pulmonary dysfunction following CABG

Impact of the components of Mediterranean nutrition regimen on long-term prognosis of diabetic patients with coronary artery disease

BACKGROUND: The impact of different nutritional regimens on long-term prognosis and outcome in diabetic patients with coronary artery disease (CAD) has been questioned. Therefore, the objective of the present study was to determine the effects of different nutritional components of Mediterranean regimen on long-term cardiovascular events in diabetic patients with CAD in the Iranian population. METHODS: In a prospective cohort study, we recruited 233 consecutive patients with the diagnosis of type 2 diabetes mellitus and with at least 6 months of documented CAD. Nutritional assessment was obtained by a validated semi-quantitative food frequency questionnaire (FFQ) and the diet score was calculated on the basis of the Mediterranean diet quality index (Med-DQI). For Assessing long-term CAD prognosis, the patients were followed by telephone for one year. The study endpoint was long-term Major Adverse Cardiac and Cerebrovascular event (MACCE). RESULTS: Death was observed in 19 patients (8.2) during the one-year follow-up. Two patients (0.9) suffered non-fatal myocardial infarction and 14 (6.0) needed revascularization within 1 year after discharge from hospital. Overall MACCE within one year in the study population was 12.4. There were significant differences between number of deaths and dietary scores of saturated fatty acid, cholesterol, meats, fish, and fruit and vegetables (P < 0.05). Moreover, significant differences were found between MACCE rate and dietary scores of saturated fatty acid, cholesterol, and fruit and vegetables (P < 0.05). Using multivariate logistic regression models, Mediterranean dietary regimen could effectively predict long-term death as well as MACCE adjusted for gender and age variables. CONCLUSION: Mediterranean dietary regimens, including low level of cholesterol and saturated fatty acid, can effectively improve long-term outcome including death and MACCE in diabetic patients with CAD

The protective effects of ginger on the development of coronary atherosclerosis: An experimental animal study

The use of ginger extracts has been recently suggested to be effective for prevention of establishing and development of coronary atherosclerosis due to its antioxidant and anti-inflammatory components. In the present study, the effect of standardized ginger extract on the development of experimentally induced atherosclerosis in animal models was investigated. The study protocol was consist of three groups of male rabbits (n = 5 each group) that were randomly divided to three groups to fed a common stock diet (containing bran and fresh vegetables) plus high cholesterol pack, or stock diet plus ginger (0.1 g/kg body weight/day) (group II) together with cholesterol, or only stock diet as the atheroma control for 75 days. Atheroma was graded macroscopically by mean graticule count percent. The degree of experimental cholesterol atherosclerosis was graded on an arbitrary scale of 0 to 4, and serum level of total cholesterol was also measured. The atherosclerotic lesion area was macroscopically smaller in rabbits that consumed ginger in comparison with the lesion area in those animals no received ginger extract (43.26 ± 8.7 mm2 versus 82.3 ± 7.9 mm2, p<0.001). Microscopically, the mean grading in coronary artery of rabbits received high cholesterol diet without ginger was 3.1±0.56, while in the group received high cholesterol diet plus ginger was 1.6±0.85 with a significant difference. Regarding effects of ginger on total cholesterol level and considering nonsignificant cholesterol level at baseline, the level of cholesterol after 75 days reached 66.72±0.12 mg/dL in the control group, 776±40.55 mg/dL in group fed high cholesterol without ginger, and 446±23.97 mg/dL in the group fed ginger with a significant level in high cholesterol plus ginger group than in high cholesterol alone group (p<0.001). Ginger can effectively protect the development of atherosclerosis manifested by lowering serum cholesterol level, as well as reducing infarct size and grade

Is herbal therapy safe in obesity? A case of apium graveolens (Celery) induced hyperthyroidism

BACKGROUND: Apium graveolens is one of the well-known herbs used for the treatment of different; however, allergic reactions have been reported after its use. This report aimed to demonstrate the A. graveolens induced hyperthyroidism after its oral consumption for weight loss. CASE REPORT: Mr. A, 48-year-old, with no history of any thyroid diseases, was diagnosed with hyperthyroidism due to daily consumption of 4 g of dried celery leaves for 45 days. After cessation of consumption and treatment with methimazole, the symptoms remitted. Then, the medication was discontinued when the lab tests and ultrasound were normal and indicated the patient’s definite recovery. In 2 months follow up of, he was normal and thyroid-stimulating hormone (TSH), T4, T3, anti-TSH receptor, anti thyroperoxidase and antithyroglobulin were in normal ranges. CONCLUSION: Hyperthyroidism may be induced by consumption celery. Although many studies have reported side effects such as allergic reactions for this herb, this is the first report of hyperthyroidism induced by celery in which the patient recovered after discontinuing the medication. Therefore, it can be assumed that celery induces hyperthyroidism as a side effect of this herb if it is used for a long term. © 2016,.Isfahan University of Medical Sciences(IUMS). All rights reserved

Exploring the Genomic Basis of Antibiotic Resistance in Wastewater E. coli: Positive Selection, GWAS, and AI Language Model Analyses

Antibiotic resistance is critical to global health. This thesis examines the relationship between antibiotic resistance and genomic variations in E. coli from wastewater. E. coli is of interest as it causes urinary tract and other infections. Wastewater is a good source because it is a melting pot for E. coli from diverse origins. The research delves into two key aspects: including or excluding antibiotic resistance data and the level of granularity in representing genomic variations. The former is important because there is more genomic data than antibiotic resistance data. Consequently, relying solely on genomic data, this thesis studies positive selection in E. coli to identify mutations and genes favored by evolution. This study demonstrates the preferential selection of known antibiotic resistance genes and mutations, particularly mutations located on functionally important locations of outer membrane porins, and may hence have a direct effect on structure and function. Encouraged by these results, the study was expanded to include antibiotic resistance data and to examine genomic variations at three resolution levels: single mutations, unitigs (genome words) that may contain multiple mutations, and whole coding genome using machine learning classifier models that capture dependencies among multiple mutations and other genomic variations. Representation of single mutations detects well-known resistance mutations as well as potentially novel mechanisms related to biofilm formation and translation. By exploring larger genomic units such as genome words, the analysis confirms the findings from single mutations and additionally uncovers joint mutations in both known and novel genes. Finally, machine learning models, including AI language models, were trained to predict antibiotic resistance based on the whole coding genome. This achieved an accuracy of over 90% in predicting antibiotic resistance when sufficient data were available. Overall, this thesis unveils new antibiotic resistance mechanisms, conducts one of the largest studies of positive selection in E. coli, and stands out as one of the pioneering studies that utilizes AI language models for antibiotic resistance prediction

A case of carbamazepine induced systemic lupus erythematous (SLE)

ABSTRACT Carbamazepine is an anticonvulsant drug that used to treat seizures and nerve pain and such as most drugs have side effect. Systemic lupus erythematous is one of connective tissue disorders that often caused by an auto immune mechanism of unknown, although some drugs cause SLE. This report aimed to demonstrate the carbamazepine induced SLE after its oral consumption for Convulsion. This is the report carbamazepine- induced systemic lupus in a 16-year-old patient who had been treated with