Background: An appropriate personalized molecular testing ensures the most efficacious treatment in lung cancer. It is still controversial whether younger lung adenocarcinoma (LUAD) patients have different molecular features compared with their older counterparts. MicroRNAs have been involved in lung cancer and their altered expression has been suggested as a potential biomarker in the pathogenesis, diagnosis, prognosis, and therapy of LUAD. Materials and Methods: To analyze putative differences in miR-25 expression between young (with age ≤50 years) and old adenocarcinoma patients, we quantified miR-25 levels with NanoString technology in 88 LUAD specimens. We further investigated a cohort of 309 LUAD patients from the cancer genome atlas (TCGA) database to test our hypothesis. Results: miR-25 expression was upregulated in young LUAD patients in comparison to the older ones (P = 0.03) in our series. The analysis of public database TCGA confirmed our results, which miR-25 differentially expressed in the two aged groups (P = 0.0009). Moreover, a consequential pairing of miR-25 with a target region in phosphatase and tensin homolog (PTEN) 3' untranslated region (UTR) and actually low PTEN expression seemed to be associated with high miR-25 (P = 0.001) in young patients. Conclusions: The interaction of miR-25 and PTEN in young LUAD may define a subgroup of patients, highlighting the concept of molecular testing in different age subtypes.

Background: Neonatal sepsis is a leading cause of death in neonates worldwide. The investigation of biomarkers for the early diagnosis of neonatal sepsis is in progress with controversial outcomes. The current report aims to evaluate the values of salivary C-reactive protein (CRP) and interleukin-18 (IL-18) for the diagnosis of neonatal sepsis. Materials and Methods: In this cross-sectional study, 89 neonates, including 49 neonatal septic case and 40 healthy group admitted at the neonatal intensive care unit, were evaluated. The salivary samples of IL-18 and CRP were measured before the antibiotic therapy initiation, as soon as blood samplings. Sepsis diagnosis was confirmed by the positive blood culture. The diagnostic values of the biomarkers were determined using the receiver operating characteristic curve (ROC curve) analysis. Besides, the sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) positive likelihood ratio (LR+), negative likelihood ratio (LR-), and diagnostic accuracy were measured. Results: Salivary CRP level was remarkably higher in septic case than healthy group (5.2 ± 4.61 vs. 3.5 ± 1.7; P = 0.02), while salivary IL-18 was not different between the groups (0.1 ± 0.29 vs. 0.04 ± 0.19; P = 0.25). The ROC curve for IL-18 showed insignificant values (P = 0.37). The ROC curve of salivary CRP showed area under the curve of 0.63 (95% confidence interval: 0.51–0.74; P = 0.03) with the sensitivity, specificity, PPV, NPV, LR+, LR − and diagnostic accuracy of 44.9% (31.8–58.7), 80% (65.2–89.5), 73.3% (55.5–85.82), 54.2% (41.6–66.3), 60.6% (50.29–70.18), 2.24 (1.57–3.2), and 0.68 (0.63–0.75) at the cutoff of 4.55 ng/L, respectively. Conclusion: Based on the findings of the current study, salivary CRP can be considered a biomarker for the early diagnosis of neonatal sepsis, while no statistical values for salivary IL-18 were detected. Due to the significance of neonatal sepsis, further evaluations are strongly recommended.

Background: The concurrence of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) is known as overlap syndrome (OS). The obstruction of the upper airway leads to OSA and the obstruction of the lower airway leads to COPD. The aim of this study was to compare polysomnographic findings of patients with OS according to severity of lower airway obstruction.Materials and Methods: Seventy-two patients were included in this cross-sectional study. Patients with COPD referred to a sleep clinic with suspicion of OSA were evaluated by polysomnography (PSG). PSG findings were interpreted based on the American Academy of Sleep Association criteria (2012). COPD severity was categorized into four groups based on GOLD criteria using forced expiratory volume in the first second (FEV₁). PSG findings also were compared between patients regarding severity of lower airway obstruction (FEV₁ ≥50% and FEV₁ <50%). Results: Sixty-eight of the patients had OS. Twenty-nine (42.6%) were male. The mean age was 62.3 ± 6.88 years. Thirty-two (54.4%) of the patients were in GOLD 2. The mean apnea/hypopnea index was 57.41 ± 36.16. Seventy-two percent of patients had severe OSA. Severe OSA was more prevalent in patients of GOLD 2 and 3 groups compared to the other groups. Among PSG findings, only N2 sleep stage was significantly longer in patients with FEV1 < 50% than in patients with FEV₁ ≥50% (61.5 ± 11.2, 55.3 ± 13.4, P = 0.039). Conclusion: Polysomnographic findings (except N2 stage) are not different in patients with OS with respect to severity of lower airway obstruction.

Background: The current study was performed to compare susceptibility-weighted imaging (SWI) with magnetic resonance imaging (MRI) methods of T2-weighted (T2W) and fluid-attenuated inversion recovery (FLAIR) imaging in multiple sclerosis (MS) plaque assessment. Materials and Methods: This cross-sectional study was conducted among 50 MS patients referred to Shafa Imaging Center, Isfahan, Iran. Patients who fulfilled McDonald criteria and were diagnosed with MS by a professional neurologist at least 1 year before the study initiation were included in the study. Eligible patients underwent brain scans using SWI, T2W imaging, and FLAIR. Plaques' number and volume were detected separately for each imaging sequence. Moreover, identified lesions in SWI sequence were evaluated in terms of iron deposition and central veins. Results: Totally 50 patients (10 males and 40 females) with a mean age of 28.48 ± 5.25 years were included in the current study. Majority of patients (60%) had a disease duration of >5 years, and mean expanded disability status score was 2.56 ± 1.32. There was no significant difference between different imaging modalities in terms of plaques' number and volume (P > 0.05). It was also found that there was a high correlation between SWI and conventional imaging techniques of T2W (r = 0.97, 0.91, P < 0.001) and FLAIR (r = 0.99, 0.99, P < 0.001) in the estimation of both the number and volume of plaques (P < 0.001). Conclusion: The results of the present study indicated that SWI and conventional MRI sequences have similar efficiency for plaque assessment in MS patients.

Nosocomial surfaces are potential pathogen reservoirs. Our aim was to describe the microbial diversity and analyze microbial patterns of healthcare-associated pathogens in two step-down-care-units at a tertiary care hospital. We monitored infected patients over 45 days to describe microbial diversity and colonization patterns. A total of 2762 isolates were recovered from the sampled sites, coagulase-negative staphylococci represented 44.64% (1233/2762) of the isolates. The most frequently recovered ESKAPE species (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter cloacae) were A. baumannii (7.53%; 208/2762 isolates) and E. faecium/Enterococcus faecalis (5.18%; 143/2762). We recovered a high diversity of species, including potential pathogens. A. baumannii was detected more frequently on diverse surfaces and persisted in patients' nostrils during the hospital stay.

Background: Drug-resistant Acinetobacter baumannii is a global health problem since its ability to acquire new resistance mechanisms. Here, we aimed to determine the association of common types of A. baumannii and assess their drug resistance of A. baumannii and contribution of integrons (Ints) and oxacillinase genes in Zanjan, Iran. Materials and Methods: Among 68 isolated Acinetobacters from patients, 48 isolates were A. baumannii strains. Antibiotic susceptibility pattern and colistin resistance were determined by disk diffusion and broth microdilution, respectively. The presence of Int I, II, III, and oxacillinase genes examined using polymerase chain reaction. The clonal relationship of clinical isolates of A. baumannii determined by Pulsed Field Gel Electrophoresis method.Results: The results showed the highest antibiotic susceptibility (58%) for colistin. 96% of isolates were considered as multidrug resistant, and 46% as extensively drug resistant, and 16% as pandrug resistant. Frequencies of Int I, II, III resistance genes were 60%, 28%, and 0%, respectively, and 12% of strains had no isoform of Ints. Frequencies of Carbapenem resistance genes were 74%, 24%, 100%, and 4% for blaOXA-23, blaOXA-24, blaOXA-51, and blaOXA-58, respectively. The above samples were group into 26 pulsotypes. Conclusion: The studied A. baumannii strains had several resistance genes, and the colistin resistance showed an extraordinary ascending tendency that could be a severe issue in nosocomial infections, and the presence of high genetic diversity indicated a variation in A. baumannii strains and possibly a variety of sources of contamination or infection.

Cancer is the second most common cause of death worldwide. It is a generic name for a large group of diseases that can affect any part of the body. Cancer affects both energy intake through the diet and the total energy expenditure (TEE) through the changes in energy metabolism, resulting in negative or positive energy balance. Determining daily energy requirement is very important in the regulation of the nutrition therapy in a cancer patients. Due to the difficulty in directly measuring the TEE, resting energy expenditure, which is the largest component of the TEE, is often used in the determination of the energy requirement. In this study, the effects of disease-specific factors such as tumor burden, inflammation, weight loss and cachexia on energy metabolism in cancer patients were investigated.

Background: Although several studies show a positive association between body mass index (BMI) and a higher risk of obstructive sleep apnea (OSA) in the general population, there are limited data on that in patients living with HIV (PLHIV). The objective of the current study is to determine the prevalence of high risk for OSA and the association between BMI and OSA in PLHIV. Materials and Methods: The study was conducted on 316 confirmed HIV cases aged ≥ 18 years who attended consulting centers in Tehran during 2019. For the diagnosis of OSA we used the Persian version of the modified Berlin questionnaire that includes ten questions broken down into three categories. A high risk for breathing problems was defined if the total score is ≥ 2. Logistic regression models were used to evaluate the association between BMI and OSA risk groups. Results: Among PLHIV, 52.1% of men and 41.6% of women were considered as high risk for breathing problems during sleep at the time of the study. Patients with a higher risk for breathing problems had significantly higher BMI levels compared to those categorized as low-risk levels (25.2 vs. 24.3 kg/m²). Each unit increase in the BMI increased the odds of being high risk for OSA by 6% in the multivariable model. (odds ratio [OR]: 95% confidence interval [CI]: 1.06: 1.01–1.13). Considering BMI categories, compared to the normal weight, being obese (BMI ≥ 30 kg/m²) increased the high risk for OSA (OR [95% CI]: 2.54 [1.10–5.89]). Conclusion: We observed a significant association between general obesity and prevalence of OSA among PLHIV.

Premature menopause can occur in women living with human HIV. In this study, we analyzed and reviewed published literature using the PubMed, Cochrane, and Embase databases since the year 1990 using a combination of MeSH terms such as “Early,” “Premature,” “Menopause,” “HIV,” and “Hormones.” Monitoring and implementation of targeted interventions for premature or early menopause among HIV-infected women might prevent or delay complications such as osteoporosis, cardiovascular diseases, and mental health issues.

Background: Cystic echinococcosis (CE) is a life-threatening disease in many countries. Albendazole, as the drug of choice for medical treatment of CE, is accompanied by adverse effects and may be ineffective in 20%–40% of cases; hence, new and more effective compounds are urgently needed to optimize the management of the disease. This study was performed to evaluate the efficacy of Zataria multiflora essential oil (ZMEO) versus albendazole against human liver CE. Materials and Methods: In this nonrandomized and single-blinded clinical trial, thirty patients who were infected with liver CE were divided into two groups (15 in each) and treated with albendazole (800 mg daily) and ZMEO (60 mg daily), respectively. Albendazole and ZMEO were administered orally for 180 consecutive days. The volume of hydatid cysts was measured by ultrasonography before and 2, 4 and 6 months after the start of treatment. Simultaneously, biochemical analysis was performed on the blood samples of patients to assess the possible side effects of the two treatment regimens. Results: Two, 4 and 6 months after the start of treatment, ZMEO indicated a significantly higher ability in reduction of the volume of the hydatid cysts, compared to albendazole (P < 0.05). The mean values of aspartate aminotransferase, alanine transaminase and alkaline phosphatase were also significantly lower in the patients treated with ZMEO in comparison to those treated with albendazole (P < 0.05). No clinical adverse effects were observed in the patients treated by ZMEO. Conclusion: From the point of view of efficacy and safety, ZMEO indicated a significant superiority to albendazole. Hence, ZMEO may be considered as an alternative for albendazole in the medical treatment of liver CE.