Journal of Research in Medical Sciences
Volume:26 Issue: 2, Feb 2021

Although antibiotics are well‑known for their anti‑bacterial effects, their inaugurated immunomodulatory roles in chronic inflammatory diseases have not elucidated yet. Anecdotal reports support the beneficial effects of parenteral penicillin in arthritis suggesting an immunomodulatory other than antibacterial effects for penicillin. The present study was designed to address the possible effects of penicillin G sodium (PCN‑G) on different T‑helper cells differentiation.

In this experimental study, peripheral blood mononuclear cells (PBMCs) of 10 healthy donors were isolated using Ficoll density gradient. The stimulated PBMCs by anti‑CD3, anti‑CD28, and anti‑CD69 were cultured in the presence of 120 μg/ml of PCN‑G. Foxp3, T‑bet, RORγT, GATA3 as well as interferon‑gamma (IFN‑γ) and interleukin (IL)‑17A mRNA in stimulated cells were measured by the real‑time polymerase chain reaction. Mann–Whitney U‑test was used for determining differences between the medium of gene expression levels of stimulated cell population and unstimulated cells by PCN. Correlations between the related genes were determined using the Spearman test.

Based on the results, T‑bet gene expression levels were similar in stimulated cells by PCN G after 24 and 48 h while significant reduction was observed after 72 incubation with PCN G (difference = 3; 0.09–0.34; P = 0.031). Meanwhile, treated cells with PCN G expressed decreased levels of IFN‑γ (difference = 8.0; 0.49–1.07; P = 0.001) and IL‑17A (difference = 2.2; 0.05–0.75; P ≤ 0.05) genes comparing to unstimulated cell by PCN‑G. GATA3 genes expression levels downregulated by PCN G after 72 h of incubation by PBMCs (difference = 1.1 ; 0.77–0.88; P = 0.035).

Our results confirmed the immunomodulatory role of PCN G by affecting the expression of different cytokines genes in PBMCs.

Visfatin is an adipokine that increased under inflammatory conditions. Moreover, sirtuin‑1 possesses regulatory
effects on inflammatory factors. In this study, we aimed to evaluate the serum level of visfatin in patients with stable and acute exacerbation of chronic obstructive pulmonary disease (AE‑COPD).

In a case–control study, thirty patients with stable COPD (S‑COPD), thirty patients with AE‑COPD, and thirty control subjects were enrolled. Pulmonary function tests and blood sampling were performed on all participants. Serum visfatin, sirtuin‑1, and interleukin (IL)‑6 levels were measured using the sandwich ELISA method and assessed their association with study parameters.

The findings of the current study revealed that serum levels of visfatin in AE‑COPD patients were higher than those of healthy controls and S‑COPD (for healthy control; standardized mean difference [SMD] = 2.63, 95% confidence interval [CI] =1.31–2.83, P < 0.001, and for S‑COPD; SMD = 1.53, 95% CI = 0.21–2.85, P < 0.05). On the other hand, the serum levels of sirtuin‑1 were higher in healthy controls compared to the S‑COPD and AE‑COPD patients (for S‑COPD; SMD = 1.56, 95% CI = 0.018–3.11, P < 0.05, for AE‑COPD; SMD = 1.50, 95% CI = 0.048–3.04, P < 0.05).

Elevated visfatin and IL‑6 levels demonstrated their pro‑inflammatory effects in patients with COPD, especially in AE‑COPD patients. In addition, the negative association found between serum visfatin and sirtuin‑1 levels suggested the pathophysiologic and therapeutic roles of these factors in COPD patients.

In situation where there are more than one cause of occurring the outcome such as recurrence after surgery and
death, the assumption of classical survival analyses are not satisfied. To cover this issue, this study aimed at utilizing competing risks survival analysis to assess the specific risk factors of local‑distance recurrence and mortality in patients with colorectal cancer (CRC) undergoing surgery.

In this retrospective cohort study, 254 patients with CRC undergoing resection surgery were studied. Data of the outcome from the available documents in the hospital were gathered. Furthermore, based on pathological report, the diagnosis of CRC was considered. We model the risk factors on the hazard of recurrence and death using competing risk survival in R3.6.1 software.

A total of 114 patients had local or distant recurrence (21 local recurrences, 72 distant recurrences, and 21 local and distant recurrence). Pathological stage (adjusted hazard ratio [AHR] = 4.28 and 5.37 for stage 3 and 4, respectively), tumor site (AHR = 2.45), recurrence (AHR = 3.92) and age (AHR = 3.15 for age >70) was related to hazard of death. Also based on cause‑specific hazard model, pathological stage (AHR = 7.62 for stage 4), age (AHR = 1.46 for age >70), T stage (AHR = 1.8 and 2.7 for T3 and T4, respectively), N stage (AHR = 2.59 for N2), and white blood cells (AHR = 1.95) increased the hazard of recurrence in patients with CRC.

This study showed that older age, higher pathological, rectum tumor site and presence of recurrence were independent risk factors for mortality among CRC patients. Also age, higher T/N stage, higher pathological stage and higher values of WBC were significantly related to higher hazard of local/distance recurrence of patients with CRC.

This study was performed to determine the sensitivity and specificity of ultrasound in the diagnosis of traumatic ankle injury in comparison with magnetic resonance imaging (MRI).

This cross‑sectional study was performed on 31 patients with soft‑tissue injury or fracture, referring to the MRI imaging center of Alzahra and Kashani Hospitals in Isfahan from October 2018 to March 2019. After an MRI, an ultrasound of the affected ankle was performed for all patients. Sonography and MRI were performed by two radiologists who were blinded to the results of each other’s reports. The sensitivity, specificity, positive predictive value, and negative predictive value of sonography were determined.

In this study, 31 patients with ankle trauma were studied. The mean age of the patients was 30.73 ± 10.15 years; 32.3% were male and 67.7% were female. The sensitivity of ultrasound relative to MRI to detect damage to the anterior talofibular ligament (ATFL), posterior talofibular ligament (PTFL), and calcaneofibular ligament (CFL) was 66.67%, 50%, and 100%, respectively, and the corresponding specificity was 92.86%, 93.10%, and 93.10%, respectively. According to Kappa test, the agreement between ultrasound and MRI methods for detecting injury to ATFL (κ = 0.51), PTFL (κ = 0.35), and CFL (κ= 0.63) was statistically significant (P < 0.05).

Ultrasound is an appropriate modality for the diagnosis of injuries to CFL and ATFL and has shown acceptable results for PTFL. It could be used as an alternative in cases where access to MRI is not available.

The present study was conducted to determine the epidemiological status, identify high‑risk and low‑risk clusters,
and estimate the relative risk (RR) of acute lymphoblastic leukemia (ALL) in provinces of Iran.

This is an ecological study carried out using an Exploratory Multiple‑Group design on 3769 children under 15 years of age with ALL from 2006 to 2014. Data analysis was performed using Mann–Whitney U, Global Moran’s I and Kuldorff’s purely spatial scan statistic tests at a significance level of 0.05.

The average annual incidence rate of ALL during 2006–2014 period was 2.25/100,000 children under 15 years of age. The most likely high‑risk cluster with log‑likelihood ratio (LLR) =327.47 is located in the southwestern part of
Iran with a radius of 294.93 km and a centrality of 30.77 N and 50.83 E, which contained 1276 patients with a RR of 2.56. It includes Fars, Bushehr, Kohgiluyeh and Boyer‑Ahmad, Khuzestan and Chahar Mahall and Bakhtiari provinces. On the other hand, the most likely low‑risk cluster with 517 patients, and a RR 0.49 and LLR = 227.03 was identified in the northwestern part of Iran with a radius of 270.38 km and a centrality of 37.25 N and 49.49 E. It includes Zanjan, Qazvin, Gilan and East Azerbaijan, Ardabil, Alborz and Tehran provinces.

High‑risk clusters were observed in Southwestern, central, and eastern Iran, while low‑risk clusters were identified in Northern and Western Iran.

Cutaneous leishmaniasis (CL) is endemic in many parts of the world with a high economic and health impact. Despite many treatments that have been suggested for this zoonotic infection, there is still no definite therapy for CL. Meglumine antimony compounds are considered as a standard treatment for leishmaniasis, however, these medications have a relatively high side effect profile and not always effective. Physical modalities including cryotherapy, laser, and heat therapy have also been used for this purpose. As a source of heat therapy, different methods have been used including radiofrequency, ultrasound, infrared, exothermic crystallization thermotherapy, and microwave. We reviewed all of the articles in PubMed regarding the use of heat therapy for the treatment of CL up to January 2020. According to our literature review, heat therapy using different sources showed promising results for the treatment of CL that were comparable to meglumine antimony. In addition, heat therapy has very low side effect profiles that are localized to the treatment area suggesting this method as a safe procedure for CL therapy. This study is a brief review of the literature about the effect of heat therapy on the treatment of CL. Performing randomized clinical trials to compare different methods of heat therapy and to compare it with meglumine antimony compounds is recommended.

Digital health as a rapidly growing medical field relies comprehensively on human health data. Conventionally, the collection of health data is mediated by officially diagnostic instruments, operated by health professionals in clinical environments and under strict regulatory conditions. Mobile health, telemedicine, and other smart devices with Internet connections are becoming the future choices for collecting patient information. Progress of technologies has facilitated smartphones, wearable devices, and miniaturized health‑care devices. These devices allow the gathering of an individual’s health‑care information at the patient’s home. The data from these devices will be huge, and by integrating such enormous data using Artificial Intelligence, more detailed phenotyping of disease and more personalized medicine will be realistic. The future of medicine will be progressively more digital, and recognizing the importance of digital technology in this field and pandemic preparedness planning has become urgent.

Metabolic syndrome (MeTS) is a well‑known health‑related problem with several end‑organ damages and the resulted side effects such as rising in the blood glucose and lipid and blood pressure. Although MeTS might show several skin symptoms such as acanthosis nigricans, skin tags, acne, and androgenic alopecia, it could also be implicated in the pathophysiology of numerous dermatologic disorders. Furthermore, some dermatologic drugs might be implicated in the incidence or exacerbation of MeTS. Consequently, MeTS and skin problem could interfere closely with each other and each one could predispose the patient to the other one and vice versa. Remembering these close relationships help us to have better therapeutic choices regarding each inflammatory skin conditions. Moreover, some of the skin symptoms should be followed cautiously to define the underlying MeTS.

Myocardial infarction (MI) with nonobstructive coronary arteries (MINOCA) is syndrome with clinical evidence of acute MI (AMI) with normal coronary arteries. This study reports the case of a 23‑year‑old single woman referring to the hospital with clinical manifestations of MI, with electrocardiography findings of slow ventricular tachycardia or accelerated idioventricular rhythm and atrioventricular dissociation, and high troponin levels, which was admitted with the diagnosis of MINOCA due to mental stress (grief) and was discharged after 4 days of monitoring and following stabilization of conditions and absence of symptoms. Other causes of MINOCA ruled out through imaging studies. Mental stress can lead to MINOCA.