Para-cardiac Inflammatory Mass Compressing the Heart: A possible association with COVID-19

Infection with the SARS-CoV-2 virus causes coronavirus disease 2019 (COVID-19). COVID-19 usually affects the lungs but may also involve other organs such as the heart. We report a case of a para-cardiac mass in a previously healthy 45-year-old man who developed persistent dyspnea following SARS-CoV-2 infection. The patient underwent cardiac surgery since the mass was attached to the pericardium and was causing constrictive pericarditis. The pathology report indicated an inflammatory pattern for the mass. Based on our knowledge there has been no previous report of developing a para-cardiac inflammatory mass after SARS-CoV-2 infection. In conclusion, we would like to increase awareness regarding the possibility of developing a para-cardiac inflammatory mass following COVID-19. Keywords: SARS-CoV-2; Pericarditis; Constrictive pericarditis; COVID-19; Cardiac tumor; Mediastinal tumor

Design, Implementation, and Evaluation of a Medical Education Fellowship Program for the Faculty Members of Kerman University of Medical Sciences Based on the Kirkpatrick Model

Background: Attempts to increase the development of faculty members can improve their ability to assume different roles. Objectives: The purpose of this study was to design, implementation, and evaluation a medical education fellowship program for the faculty members of Kerman University of Medical Sciences and to propose practical recommendations for the future design of development programs. Methods: In this semi-experimental study, a total of 53 faculty members of Kerman University of Medical Sciences participated in a one-year development program, which was designed by the Education Development Center and included the main disciplines of medical education. The program was evaluated in several steps, using the Kirkpatrick model. Results: In the first level of Kirkpatrick model, the majority of the participants were satisfied with the general quality of the fellowship program. Based on the findings, the program led to an increase in the knowledge of faculty members and promoted a more positive attitude towards education and these programs. The findings related to the second level of Kirkpatrick model showed a significant difference between the pretest and posttest results (P < 0.05). In addition, analysis of the effects of the program on the participants’ behaviors and practical learning indicated positive changes. Conclusions: The medical education fellowship program led to positive changes in the participants’ attitudes towards education and faculty development programs and increased their knowledge about educational principles and strategies and achieving of training skills. It can be concluded that the medical education fellowship program could achieve many of its preset goals. Keywords Faculty Development Programs Medical Education Faculty Member

Scolicidal effects of biogenic selenium nanoparticles against protoscolices of hydatid cysts

Cystic echinococcosis (hydatid cyst, CE) as a zoonotic parasitic infection caused by the larval stage of the dog tapeworm Echinococcus granulosus is still an important economic and public health concern in the world. One of the treatment options for CE is surgical removal of the cysts combined with chemotherapy using albendazole and/or mebendazole before and after surgery. Currently, many scolicidal agents, which have some complications, have been used for inactivation of the cyst contents. Therefore the development of new scolicidal agents with low side effects and more efficacies is an urgent need for surgeons. The present study was aimed to investigate the in vitro scolicidal effect of selenium nanoparticles biosynthesized by a newly isolated marine bacterial strain Bacillus sp. MSh-1 against protoscoleces of E. granulosus. Protoscolices were aseptically aspirated from sheep livers having hydatid cysts. Various concentrations (50e500 mg/ml) of Se NPs (in size range of about 80e220 nm) were used for 10e60 min. Viability of protoscoleces was confirmed by 0.1% eosin staining. The results indicated that biogenic Se NPs at all concentrations have potent scolicidal effects especially at concentrations 500 and 250 mg/ml after 10 and 20 min of application, respectively. In conclusion, the findings of present study proven that Se NPs have potent scolicidal effects, therefore may be used in CE surgery. However, the in vivo efficacy of these NPs remains to be explored

A genetic variant in the cytochrome P450 family 2 subfamily R member 1 determines response to vitamin D supplementation

Background Globally, about 1 billion people have inadequate levels of serum vitamin D and it is prevalent in all ethnicities and age groups. Few foods naturally contain sufficient vitamin D; therefore, most people get their requirements through supplementation. Hence vitamin D status is affected by genetic and environmental determinants including season of measurement, diet habitual, health status, body mass index and concurrent medication. Further studies are necessary to understand how genetic variation influences vitamin D metabolism. We aimed to explore the association between a potential vitamin D-related polymorphism (the rs10766197 polymorphism in the CYP2R1 gene) with the response to supplementation of vitamin D in 253 healthy Iranian girls. Material and method A total of 253 healthy subjects received 50,000 IU of vitamin D3 weekly for 9 weeks. Serum 25(OH)D concentrations and metabolic profiles were measured at baseline and after 9 weeks of supplementation. The genotypes of the CYP2R1 variant (rs10766197) were identified using TaqMan genotyping assays. Results Serum 25(OH)D during the supplementation, increased in all individuals. Subjects with a AA major genotype at this locus had higher vitamin D concentrations after intervention (Changes (%) 448.4% ± 425% in AA vs 382.7% ± 301% in GG). This genetic variant modulated the response to supplementation (p < 0.001 and p-value SNP = 0.05). Regression analysis showed that the probability of affecting serum 25(OH)D, in individuals who had homozygous major allele GG was two-fold higher than carriers of the uncommon allele A (OR = 2.1 (1–4.2); p = 0.03). Interestingly, the Hs-CRP was reduced in AA carries while was elevated in individuals with GG and AG genotypes, after high-dose vitamin D supplementation. Conclusion Changes in serum vitamin D and metabolic profile following high dose supplementation with vitamin D were associated with CYP2R1 polymorphism. Although carriers of the common G allele showed a greater response in the serum vitamin D

Effects of antimony on enzymatic and non-enzymatic antioxidants in a metallicolous and a non-metallicolous population of Salvia spinosa L

The present study aimed at elucidating the role of antioxidants and stress metabolites in antimony (Sb) tolerance in a metallicolous (M), Sb[V]-hypertolerant population, and a non-metallicolous (NM) population of Salvia spinosa, particularly with regard to the question of whether they could be involved in constitutive Sb tolerance or, specifically, in Sb[V] hypertolerance in the M population. Plants were exposed in hydroponics to 0, 8, 24, 74, 221 μM Sb (Ш or V). Superoxide dismutase (SOD), ascorbate peroxidase (APX) and catalase (CAT) activities, and the concentrations of phenolics, flavonoids, and proline in leaves were measured after 20 d. As potential stress/tolerance markers, the concentrations of chlorophyll a and b, anthocyanins, and those of total soluble and reducing sugars were also measured. Chlorophyll a concentration reflected the difference, both in Sb[III] and Sb[V] tolerance, between N and NM, and the higher toxicity of Sb[III], compared to Sb[V]. APX and proline accumulation were more induced in M than in NM, and more by Sb[V] than by Sb[III], which is theoretically compatible with a role in Sb[V] hypertolerance. CAT was more induced in M than in NM, but more by Sb[III] than Sb[V], suggesting that is not functional in Sb[V] hypertolerance. The other enzymes and compounds did not exhibit significant Sb redox status*population interactions, suggesting that they don't play a role in, specifically, Sb[V] hypertolerance in M, but at most in the constitutive Sb[III] or Sb[V] tolerance of the species

Antimony tolerance and accumulation in a metallicolous and a non-metallicolous population of Salvia spinosa L.

Aims: Antimony (Sb) is locally found at potentially toxic concentrations in mineralized soils, usually together with arsenic (As). However, local adaptation of plant populations to Sb toxicity has never been shown thus far. Here we compared Sb tolerance and accumulation between a non-metallicolous (NM) population of Salvia spinosa, and a con-specific metallicolous (M) population from a strongly Sb/As-enriched soil in Dashkasan, Iran. Methods: Plants were exposed in hydroponics to a series of Sb[III] and Sb[V] concentrations. After 3 weeks the dry weights and Sb concentrations of roots and shoots were determined. Results: Estimated from the effects on shoot dry weight, the M population was more tolerant than the NM one, particularly to Sb[V], but to a lower degree also to Sb[III]. In both populations Sb[III] was taken up and translocated at higher rates than Sb[V]. The Sb concentrations in roots and shoots were slightly, but significantly higher in the M than in the NM population. Conclusions: Since Sb[V] and As[V] seem to follow very different detoxification pathways, it can be argued that the superior tolerance to Sb[V] in M represents a local adaptation to Sb[V] toxicity itself, rather than being a mere by-product of hypertolerance to its chemical analogue, As[V]. Since Sb[III] and As[III] or As[V] share common detoxification pathways, the apparent Sb[III] hypertolerance in the M population might represent a by-product of As hypertolerance

Frequency of abnormal findings in lumbar MRI in patients With non traumatic and non surgical low back pain referred to Imam-Khomeini Hospital

Background: This study was conducted to determine the frequency of abnormal discal findings in lumbar MRI in patients with non traumatic non surgical low back pain who referred to Imam-Khomeini hospital Materials and methods: This study was conducted as a descriptive &ndash; analytical cross-sectional prospective survey among 280 consecutive patients who referred to Imam-Khomeini hospital in 2008 -2009. The data were collected by check list and analysis was done by SPSS 10 Results: The mean age of the patients was 40.98. 56.1% were female Abnormal MRI was seen in 83.2% and 72.9% had disc involvement including 40.7% central, 21.1% right and 36.3% left involvements, 25.75% had bulging, 62.85% protrusion, 11.05% extrusion and finally 0.35% had sequestration. Conclusion: It may be concluded that disc protrusion and bulging are the most common findings in MRI and according to excellent ability of MRI in diagnosis of herniation, MRI is recommended in patients with non surgical non traumatic low back pain

Imaging features of estrogen-negative breast cancers: a correlation study with human epidermal growth factor type II overexpression

Background: Estrogen-negative breast cancers have different clinical course, prognostic features and treatment response in comparison to estrogen receptor-positive (ER-positive) breast cancers. Human epidermal growth factor receptor 2 (HER2) oncoprotein has found to have a pivotal role in natural cell growth and cell division and is suggested to be directly related to tumor invasiveness in breast cancer patients. The purpose of this study was to retrospectively assess the mammography, ultrasound, and magnetic resonance imaging (MRI) features of estrogen negative breast cancers with and without overexpression of HER2/neu receptor. Methods: In this cross-sectional retrospective study, mammographic, ultrasound and MRI features as well as HER2 status were assessed in patients with ER-negative breast cancer that were referred to Cancer Institute of Imam Khomeini Hospital Complex in Tehran from October 2015 to October 2017. Clinicopathologic data and mammography, ultrasound, and MRI features were reviewed and were correlated with HER2 status of estrogen-negative tumors. Results: Of the 172 patients with ER-negative breast cancer, 101 patients were positive for HER2/neu receptor (58.8%). There was a significant correlation between HER2-positivity and tumor type (P=0.004). Among estrogen negative breast cancers, significant association were found between HER2 and tumor histologic grade (P=0.024) and TNM stage (P=0.021). HER2-positive tumors were more likely to present with microcalcification (P=0.007) and have irregular shapes (P=0.034) in mammography than HER2-negative tumors. No association was found between HER-2 status and tumor size, shape, margin, posterior feature, halo or orientation of the tumor in ultrasound. We also found no correlation between HER2 status and MRI features including mass shape or margin, internal enhancement pattern or curve type among estrogen-negative breast cancers. Conclusion: Findings of this study showed that among estrogen-negative breast cancers, HER2/neu positive tumors are more likely to be diagnosed at higher stage and have higher histologic grade at the time of diagnosis. Tumor mass shape and microcalcification in mammography are found to be associated with HER2 status among patients with estrogen-negative breast cancer