The Therapeutic Effect of Endoscopic Tumor Resection on Acromegalic Cardiomegaly in Patients With Pituitary Adenoma

Background: Acromegaly defines as chronic elevations of insulin-like growth factor-1 (IGF-1) and growth hormone (GH), which results in enlargement of organs and soft tissues. Cardiovascular complications of acromegaly such as cardiomegaly, hypertension contributing to a high risk of cardiovascular events. This study aimed to identify the determinants of the prevalence of cardiomegaly as cardiovascular comorbidity of acromegaly and the potential effect of the curative intervention.Methods: A total of 160 patients with acromegaly due to pituitary adenoma participated in this study. Acromegaly diagnosed was based on clinical manifestations, age-adjusted plasma IGF-I, and elevated plasma GH levels, not suppressible during an oral glucose tolerance test (75 g). Electrocardiogram and chest X-ray obtained in all patients. Treatment approaches included transsphenoidal surgery and hormonal evaluation performed before and six months after surgery.Results: The GH serum level was elevated in all patients before surgery, with a mean of 33.7 ng/mL that reached 5.7 ng/mL after surgery. Mean IGF-1 was 794.1 ng/mL that reached 395.6 ng/mL postoperatively. The prevalence of cardiomegaly was 15% that improved in 5% of patients after trans sphenoidal surgery.Conclusion: Appropriate surgical intervention in acromegaly that complicated by cardiomegaly may result in significant improvement of the cardiac structure

Development of Novel Hybrid Silica Aerogels with a Reticulated Structure using New Generation of Marcromolecular Precursors

Aerogels (e.g. silica aerogel) have created a prospective market for oil-absorption, insulation and aerospace applications. However, their intrinsic fragility and poor mechanical properties have been a stumbling block to their wider applications. These drawbacks originate from their inherent particulate structure and weak interparticle interactions. For several decades, researchers have been trying to enhance the aerogels’ mechanical properties by improving the particle-to-particle connections. However, the cost was increased processing time, increased density, and increased total thermal conductivity. Therefore, this Ph.D. research aims to find an industrially viable and fast manufacturing technology to produce ultra-light weight and mechanically robust and resilient aerogel while preserving the unique features of the aerogels such as the good thermal insulation properties and high surface area. This dissertation fundamentally addressed the difficulties associated with the improvement of the particle-to-particle connection in the conventional aerogels by inventing a novel non-particulate and reticulate structure, free from the troublesome particles. This new technology relied on the development of a new generation of polymeric silica precursor and a meticulous control of thermodynamics at gelation step. Polymeric precursors with different chemistries and molecular weights were synthesized in the preparatory stage and then through spinodal decomposition, non-particulate and reticulate aerogels were afforded. Thermodynamics variables, molecular weight of the polymeric precursor, solvent, temperature, and the amount of the nonsolvent were systematically studied and correlated to structural parameters and consequently to the final properties. It was found that there is a critical point where a particulate structure transfers to a non-particulate one. The findings have also demonstrated how to tailor the structural factors such as the void fraction, the average pore sizes to optimize the final properties. This study provided an in-depth understanding of processing-structure-property relationship and a novel technology to molecularly engineer the structure and properties of hybrid silica aerogels. Various aerogels’ building blocks assemblies, polymeric precursors, and thermodynamics variables have been investigated to identify the optimal structure and processing methodology to obtain highly robust and super-insulative aerogels.Ph.D.2021-06-22 00:00:0

Eosinophils in the tumor microenvironment: implications for cancer immunotherapy

Abstract Despite being an integral part of the immune response in the tumor microenvironment (TME), few studies have mechanistically elucidated eosinophil functions in cancer outcomes. Eosinophils are a minor population of granulocytes that are mostly explored in asthma and allergic disorders. Their influence on primary and metastatic tumors, however, has recently come to light. Eosinophils’ diverse armamentarium of mediators and receptors allows them to participate in innate and adaptive immunity, such as type 1 and type 2 immunity, and shape TME and tumor outcomes. Based on TME cells and cytokines, activated eosinophils drive other immune cells to ultimately promote or suppress tumor growth. Discovering exactly what conditions determine the pro-tumorigenic or anti-tumorigenic role of eosinophils allows us to take advantage of these signals and devise novel strategies to target cancer cells. Here, we first revisit eosinophil biology and differentiation as recognizing eosinophil mediators is crucial to their function in homeostatic and pathological conditions as well as tumor outcome. The bulk of our paper discusses eosinophil interactions with tumor cells, immune cells—including T cells, plasma cells, natural killer (NK) cells—and gut microbiota. Eosinophil mediators, such as IL-5, IL-33, granulocyte–macrophage colony-stimulating factor (GM-CSF), thymic stromal lymphopoietin (TSLP), and CCL11 also determine eosinophil behavior toward tumor cells. We then examine the implications of these findings for cancer immunotherapy approaches, including immune checkpoint blockade (ICB) therapy using immune checkpoint inhibitors (ICIs) and chimeric antigen receptor (CAR) T cell therapy. Eosinophils synergize with CAR T cells and ICB therapy to augment immunotherapies

Epidemiological Status of Dermatophytosis in Guilan, North of Iran

Background and Purpose: The epidemiological features of dermatophytoses have been characterized in many geographical locations of Iran, but not in Guilan, North of Iran. This study was carried out to determine the distribution pattern of dermatophytoses and their relevant agents in Guilan, North of Iran, over a period of one year, from April 2010 to April 2011. Materials and Methods: The clinical samples of skin, hair, and nail from 889 outpatients (317 men vs. 572 women) were used for direct microscopy and culture. All the culture-positive samples were then subjected to amplification of the internal transcribed spacer (ITS) of the nuclear rDNA followed by a restriction fragment length polymorphism (RFLP) assay to verify the causative agents. Results: The infection was confirmed in 90 (44.3%) males and 113 (55.7%) females.The most common type of dermatophytoses was tinea cruris (42.9%), followed by tinea pedis (20.2%), tinea corporis (11.3%), tinea unguium (7.4%), tinea faciei (6.9%), tinea manuum (6.4%), and tinea capitis (4.9%). ITS-RFLP based of the identification of isolates, showed that the infections were significantly associated with anthropophilic species, of Trichophyton rubrum (41.9%), Epidermophyton floccosum (19.7%), T.tonsurans (5.4%), and T. violaceum (2%). Other causative agents were T. interdigitale (22.6%),Microsporum canis (4.9%), T. verrucosum (2.5%), and M. gypseum. (1%). Conclusion: The higher prevalence of T. rubrum, as the agent of dermatophytoses, than other species has never been reported from Iran and is of public health concern because of the chronic nature of infections with anthropophilic species. To thoroughly investigate the epidemiological trend of dermatophytoses in Iran, further periodical and molecularbased studies are necessary. &nbsp

Synchronous Identification of Entamoeba histolytica, Giardia intestinalis, and Cryptosporidium spp. in Stool Samples Using a Multiplex PCR Assay

Background: Diarrheal disease annually causes 760000 deaths in children, and 1700 million new cases are reported each year worldwide. Among the parasites, Entamoeba histolytica, Giardia intestinalis, and Cryptosporidium spp. are the most important infectious agents leading to diarrhea. Clinical presentations due to these parasites are more or less similar, and microscopy is not as much as sensitive for the detection. The aim of this study was to set up and evaluate a Multiplex PCR Assay for Synchronous Identification of Entamoeba histolytica, Giardia intestinalis, and Cryptosporidium spp. in Stool Samples Methods: Samples were obtained from different sources such as culture media and patient stool samples. Primer pairs were designed using primer-BLAST, and for the extraction of DNA, the QIAamp DNA stool mini kit was used. The study was conducted in Tehran, Iran and completed in 2016. Results: The current multiplex PCR assay for the detection of E. histolytica achieved sensitivity and specificity of 86.36% (95% CI: 65.09% to 97.09) and 95.74 % (95% CI: 85.46% to 99.48%), respectively. Sensitivity and specificity of the test for G. intestinalis was 90.91% (95% CI: 70.84% to 98.88%) and 95.74% (95%CI: 85.46% to 99.48%), respectively, and for the detection of Cryptosporidium, multiplex PCR showed a sensitivity of 90.91% (95% CI: 70.84% to 98.88%) and specificity of 95.74% (95%CI: 85.46% to 99.48%). Conclusion: Multiplex PCR in this study showed admissible sensitivity and specificity for the detection of E. histolytica, G. intestinalis, and Cryptosporidium spp. in fecal samples

Evaluation of a New Primer In Comparison With Microscopy for the Detection of Giardia lamblia Infection in Stool Samples

Background: Among the most important parasitic disease, causing diarrhea, Gi­ardia lamblia is noteworthy. Nowadays detection methods for these parasites in­clude parasitological methods such as microscopic examination. The sensitivity of these methods relies on the expertise and experience of examiners. In contrast, molecular methods such as PCR are less dependent on the expertise of the exam­iner. Here we developed a PCR for the detection of G. lamblia genome in stool samples in comparison with microscopy, which is the gold standard. Methods:  For the evaluation of primers, 22 positive samples and 47 negative samples were used. QIAamp DNA Stool Mini Kit (QIAGEN, Germany) was used for DNA extraction from feces. Primers for PCR were designed using Primer-BLAST which uses Primer 3 to designing specific primers (NCBI/ Primer-BLAST). Results: Sensitivity of the PCR was done with 100% (95%CI: 84.56-100) for the detection of G. lamblia DNA isolated from patients stool samples which were posi­tive for G. lamblia cysts and/or trophozoites using microscopy as gold standard. In comparison with microscopy, PCR had showed the specificity of 97.87% (95%CI: 88.71-99.95). Conclusion: We designed new primers for the Giardia, and PCR method for the rapid and accurate identification of Giardia parasites established. With considera­tion to the routine diagnosis techniques in medical parasitology and their limita­tions such as time consuming, laborious, less sensitivity etc. This G. lamblia PCR is a sensitive and specific application for the diagnosis of G. lamblia and provides us a reliable method in the routine intestinal parasitic infection laboratory diagnosis

Rare Presentation of MoyaMoya Disease with Sub acute Presentation: A Case Report from Iran

AbstractMoyamoya disease is  a  chronic  progressive  vascular  disease of  brain  has  been characterized  by  bilateral  stenosis or occlusion  of   the  arteries  around  the  circle of   Willis with prominent  arterial  collateral  circulation. We introduce  a  patient  with  Moyamoya  that  was  been   misdiagnosed.We report  a  16-year-old  female  from  northeast  of  Iran  who complained  left hemiparesis  and  was diagnosed  Moyamoya disease  by  brain and cervical CT-Angiography. There is still great difficulty in the diagnosis of diffuse white matter lesions and our case shows that moyamoya disease should be considered in differential diagnoses especially among young patients presenting with unexplained cerebrovascular syndromes. The   CT-Angiography  showed   bilateral  internal  carotid  stenosis   with  "puff of smoke" collateralization  arising  from  the  circle of Willis, therefore  Moyamoya disease was raised.The   clinical  diagnosis  of  Moyamoya  is  challenging   and   misdiagnosis   is    probable. Therefore,   the  physicians    should  know  this   disease   and   think  about  it  in  patients   with   Juvenile   stroke

Validation of Persian version of PHQ-9 for diagnosis of major depressive episode in psychiatric wards in IRAN

Major depressive disorder is one of the most serious and disabling psychiatric disorders. It can be followed by medical problems, impaired individual functioning, reduced quality of life and mortality (1-3). The prevalence varies among different countries. This discrepancy depends on genetics, environmental parameters, racial factors, cultural differences in perceiving diagnostic parameters, psychometric characteristics of diagnostic tools and sampling protocol (3). Major depressive episode may happen during major depressive disorder (unipolar depression) and also in bipolar disorder type I and II patients

Recovery scenario and immunity in COVID-19 disease: A new strategy to predict the potential of reinfection

Background: The recent ongoing outbreak of coronavirus disease 2019 (COVID-19), still is an unsolved problem with a growing rate of infected cases and mortality worldwide. The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is targeting the angiotensin-converting enzyme 2 (ACE2) receptor and mostly causes a respiratory illness. Although acquired and resistance immunity is one of the most important aspects of alleviating the trend of the current pandemic; however, there is still a big gap of knowledge regarding the infection process, immunopathogenesis, recovery, and reinfection. Aim of Review: To answer the questions regarding “the potential and probability of reinfection in COVID-19 infected cases” or “the efficiency and duration of SARS-CoV-2 infection-induced immunity against reinfection” we critically evaluated the current reports on SARS-CoV-2 immunity and reinfection with special emphasis on comparative studies using animal models that generalize their finding about protection and reinfection. Also, the contribution of humoral immunity in the process of COVID-19 recovery and the role of ACE2 in virus infectivity and pathogenesis has been discussed. Furthermore, innate and cellular immunity and inflammatory responses in the disease and recovery conditions are reviewed and an overall outline of immunologic aspects of COVID-19 progression and recovery in three different stages are presented. Finally, we categorized the infected cases into four different groups based on the acquired immunity and the potential for reinfection. Key Scientific Concepts of Review: In this review paper, we proposed a new strategy to predict the potential of reinfection in each identified category. This classification may help to distribute resources more meticulously to determine: who needs to be serologically tested for SARS-CoV-2 neutralizing antibodies, what percentage of the population is immune to the virus, and who needs to be vaccinated