Comparative evaluation of the therapeutic strategies using a minimal model of luminal-A breast cancer

Cellular behavior is heavily influenced by cellular interactions, which are often lost in conventional cell culture methods. As a result, in vitro cellular behavior may not accurately reflect in vivo conditions. Three-dimensional (3D) culture, on the other hand, is better suited for studying cellular behavior as it allows for more comprehensive cell communication. In this study, we utilized 3D culture of the MCF-7 cell line to create a minimal model of luminal-A breast cancer and evaluated its histopathological and morphological features using various methods. To determine the optimal therapeutic strategies for eliminating cancer cells, we assessed the effectiveness of diverse therapeutic approaches, including targeting distinct phases of the cell cycle, endocrine therapy, and gene therapy in both 2D and 3D culture systems. Our findings indicate that cells derived from mammospheres respond differently to their parent cells in monolayer culture depending on the therapeutic strategy used. This variability in drug response may be due to the altered microenvironment created by heterogeneous cellular makeup and emerging cellular interactions in the 3D culture. Therefore, it is important to administer a therapeutic approach that can eradicate cells regardless of the microenvironment.

Cancer patients and targeted therapy during COVID-19 pandemic: A descriptive case series study

To evaluate the effectiveness of targeted therapy on preventing or treating COVID-19, in this study, we want to share our experience about 14 patients (nine women, five men; average age, 59 years) who were treated with targeted therapy due to their underlying malignant disorders in our center.

Red cell distribution width, a predictive factor in immunocompromised patients with COVID-19: A comparison retrospective study between cancer and kidney transplant patients

We aimed to review the records of cancer and kidney transplant patients of out of 1135 COVID-19 patients, who were referred to our hospital (Valiasr) in Zanjan, from March 16th, 2020, to June 11th, 2020. This was single-center, historical cohort study. Patients were divided into different subgroups and compared of disease outcomes. The only predictor of death was lactate dehydrogenase (LDH). The rate of red cell distribution width (RDW) in patients with active cancer was higher than kidney transplant patients and was statistically significant. There was no statistically significant difference in mortality between active and non-active cancer groups. Female sex and low SpO2 has increased the chances of ICU admission. Patients with active cancer generally have severe and more complicated disease and RDW can be a predictable option.

Case Report of 78-Year-Old Man With Meningitis, Pulmonary Thromboembolism and SARS-Coronavirus-2 Infection

The novel coronavirus infection involves both the Central and Peripheral Nervous systems. Some of the presentations include acute cerebrovascular disease, impaired consciousness, transverse myelitis, encephalopathy, encephalitis, and epilepsy. Our patient was a 78-year-old man with dementia and diabetic nephropathy who was admitted two times for possibly COVID-19 infection. At the first hospitalization, the patient is treated with hydroxychloroquine and Kaletra based on clinical symptoms and initial laboratory findings due to suspicion of COVID-19. After the negative RT-PCR test of the nasopharyngeal sample for COVID-19 and evidence of aspiration pneumonia in CT scan, the patient was discharged with oral antibiotics. Five weeks later, he was rehospitalized with loss of consciousness, fever, and hypoxemia in the physical exam; he had neck stiffness in all directions, So the central nervous system (CNS) infection was suspected, the cerebrospinal fluid (CSF) sample was in favor of aseptic meningitis and second RT-PCR test of nasopharyngeal sample for COVID-19 was positive, but Brain MRI just showed small vessel disease without evidence of encephalitis. In the second hospitalization, he had acute renal failure, which was treated with supportive care, and also suffered from pulmonary embolism with cavitary lesions in his lungs. Meningitis with pulmonary embolism and acute renal failure have not yet been reported. Our patient is the first one, so we decided to share it. This case showed a different presentation of COVID-19 without typical lung involvement. So, we must pay attention to any signs and symptoms in a patient suspected of having a COVID-19.

Clinical patterns of endothelial damage and thrombotic events in two patients with COVID-19: A case report

Endotheliopathy causes COVID-19 conflicting complications.

Dermatomyositis following Biosimilar Trastuzumab in a Breast Cancer Patient: A Case Report

Trastuzumab, as a recombinant IgG1 kappa, is a humanized monoclonal antibody against human epidermal growth factor receptor 2. Accordingly, it is widely used in breast cancers at early and advanced stages. Dermatomyositis is a rare adverse event of trastuzumab therapy, which is not well documented yet. In this study, a patient was treated for invasive ductal carcinoma with some symptoms of rash and generalized fatigue. These symptoms started after the fifth cycle of trastuzumab, which were gradually deteriorating. This patient's medical and family histories were unremarkable. The progression of the disease was ruled out as a possible cause of dermatomyositis, and the laboratory evaluation revealed a moderate increase in serum muscle protein (CPK). So, trastuzumab treatment was discontinued, and by passing 1 month from the start of prednisolone and hydroxychloroquine, the patient had no symptoms.

Correlation between CSF biomarkers and COVID-19 meningoencephalitis: A case series

BACKGROUND

Recent studies have focused on the incidence rate and pattern of meningoencephalitis in the coronavirus disease 2019 (COVID-19).

AIM

This study aims to shed more light on the CSF pattern and clinical characteristics of meningoencephalitis COVID-19 patients in Zanjan, Iran.

METHODS

Nine cases of laboratory and imaging confirmed COVID-19 were admitted to Valiasr Hospitals in Zanjan, Iran. Data were collected from May 20, 2020 to June 20, 2020.

RESULTS

All the nine patients had positive RT-PCR COVID-19 and Pulmonary involvement who underwent Lumbar puncture and analysis, but despite neurological symptoms, the RT-PCR of CSF for COVID-19 was negative.

CONCLUSION

Although we did not have any cases of positive RT-PCR for COVID-19 in lumbar puncture specimens, the justification of neurological symptoms in patients can be the transient presence of the virus in the CSF, and inflammation or autoimmune response caused by the virus, so more studies are needed to determine the cause of neurogenic symptoms.

Incidence of symptomatic venous thromboembolism following hospitalization for coronavirus disease 2019: Prospective results from a multi-center study

Background

Thrombosis and pulmonary embolism appear to be major causes of mortality in hospitalized coronavirus disease 2019 (COVID-19) patients. However, few studies have focused on the incidence of venous thromboembolism (VTE) after hospitalization for COVID-19.

Methods

In this multi-center study, we followed 1529 COVID-19 patients for at least 45 days after hospital discharge, who underwent routine telephone follow-up. In case of signs or symptoms of pulmonary embolism (PE) or deep vein thrombosis (DVT), they were invited for an in-hospital visit with a pulmonologist. The primary outcome was symptomatic VTE within 45 days of hospital discharge.

Results

Of 1529 COVID-19 patients discharged from hospital, a total of 228 (14.9%) reported potential signs or symptoms of PE or DVT and were seen for an in-hospital visit. Of these, 13 and 12 received Doppler ultrasounds or pulmonary CT angiography, respectively, of whom only one patient was diagnosed with symptomatic PE. Of 51 (3.3%) patients who died after discharge, two deaths were attributed to VTE corresponding to a 45-day cumulative rate of symptomatic VTE of 0.2% (95%CI 0.1%–0.6%; n = 3). There was no evidence of acute respiratory distress syndrome (ARDS) in these patients. Other deaths after hospital discharge included myocardial infarction (n = 13), heart failure (n = 9), and stroke (n = 9).

Conclusions

We did not observe a high rate of symptomatic VTE in COVID-19 patients after hospital discharge. Routine extended thromboprophylaxis after hospitalization for COVID-19 may not have a net clinical benefit. Randomized trials may be warranted.

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In a large multi-center study, the incidence of venous thromboembolism in COVID-19 patients followed for 45 days after hospitalization was relatively low.

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Routine extended thromboprophylaxis in COVID-19 patients who have been discharged from the hospital may not have a net clinical benefit.

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Older age, history of recent cancer, and history of recent diabetes were associated with higher risk of mortality after hospital discharge

Circulating Irisin Levels and Redox Status Markers in Patients with Gastric Cancer: A Case-Control Study

Objective:

Irisin, mostly known as an exercise-induced fat browning myokine, has been recently detected in several cancer cells, and its potential for being utilized as a biomarker for early diagnosis of some cancers, such as Gastric cancer (GC), is the subject of speculation. The present study aims to compare serum irisin levels in GC patients and healthy controls and assess the interrelation between irisin and oxidative stress markers.

Methods:

In this case-control study, 22 newly diagnosed GC patients and 29 healthy controls were recruited based on the inclusion criteria. Serum levels of irisin were quantified in duplicates by ELISA. Oxidative stress indices, including total antioxidant power in sera, thiol group, malondialdehyde, and superoxide dismutase concentrations, were also measured in both groups. An independent-sample t-test was used to compare the means between the two studied groups.

Results:

Serum levels of irisin were significantly higher in the GC group compared with those of their healthy counterparts (p =0.032). No significant differences were observed between the two groups in terms of the serum total antioxidant power or the oxidative stress marker, including MDA, thiol groups, and SOD concentration in sera. Furthermore, there was no significant association between irisin, FRAP, the Thiol group, and the SOD activity.

Conclusion:

According to the finding, the increased serum levels of irisin in GC patients can play a potential role in the early diagnosis of the GC patients; hence, this peptide can be employed as a new diagnostic indicator of GC.

While Urine and Plasma Decorin Remain Unchanged in Prostate Cancer, Prostatic Tissue Decorin Has a Prognostic Value

Background

Numerous studies confirmed that significant decrease in tissue decorin (DCN) expression is associated to tumor progression and metastasis in certain types of cancer including prostate cancer (PC). However, the potential prognostic value of tissue DCN in PC has not yet been investigated.

Methods

A total number of 40 PC and 42 patients with benign prostatic hyperplasia (BPH) were investigated for the expression levels of DCN in their prostatic tissues using real-time quantitative polymerase chain reaction and immunohistochemical analyses. Urinary and plasma DCN levels were also measured by ELISA.

Results

Despite no significant changes in the mean of urine and plasma DCN concentrations between the two study groups, tissue DCN mRNA was found to be 5.5fold lower in cancer than BPH (p = 0.0001). Similarly, the stained DCN levels appeared significantly lower in cancer patients with higher Gleason Scores (8 and 9, n = 6) than those with lower Gleason Scores (6 and 7, n = 26), with a p value of 0.049.

Conclusion

Here, we report, for the first time, that urine and plasma DCN does not seem to have a diagnostic value in PC, while tissue DCN could potentially be used as a prognostic marker in PC.

HER2 Expression Status and Prognostic, Diagnostic, and Demographic Properties of Patients with Gastric Cancer: a Single Center Cohort Study from Iran

Background: The fourth most prevalent cancer worldwide and a major cause of death in developing countries is gastric cancer (GC). Human epidermal growth factor receptor 2 (HER2), is a proto-oncogene expressed in different solid tumors. This study aimed to evaluate possible associations of HER2 expression status with survival rate, age, sex, tumor grade, histopathological type, and primary tumor location in patients with GC. Methods: Subjects were enrolled in this cohort study after consideration of inclusion and exclusion criteria. Biopsy specimens were stained using immunohistochemistry. Samples with a score of 3+ were considered to exhibit HER2 overexpression. The mentioned variables were extracted from patients’ files as well as by clinical evaluation. The Kaplan-Meier method was applied for analyzing the survival rate and Chi square for possible factor associations. Results: A total of 210 patients (25.2% female and 74.8% male) were enrolled. In a 5-year follow-up (adherence rate: 45.7%), the average survival was 9.4±10.9 months. HER2 overexpression was evident in 24%. There was no statistically significant association found between HER2 expression and primary tumor location (p-value=0.63), histopathological type (p-value=0.72), or tumor grade (p-value=0.051). Furthermore, no statistically significant links were apparent with tumor grade in either male or female groups as well as patients aged ≥60 and ˂60 years (all p-values >0.05). Moreover, no statistically significant association was detected between HER2 expression status (p-value=0.88), sex (p-value=0.31), and age (p-value=0.055) with patient survival. Conclusions: No statistically meaningful association was found between all parameters examined and HER2 expression status. Divergence of the results from earlier studies might be due to genetic variation. Thus, performing a meta-analysis on certain races might be helpful for clarification.

Hopelessness, Perceived Social Support and their Relationship in Iranian Patients with Cancer

Objective:

Cancer is considered a global health problem and its prevalence has been growing in recent years. The present study was conducted to investigate the role of hopelessness and perceived social support for Iranian patients with cancer.

Methods:

Convenience sampling was used to select the study sample comprising 100 patients with cancer presenting to the Education and Treatment Center of Valiasr in Zanjan, Iran. A demographic questionnaire, the Beck Hopelessness Scale, and the Social Support from Family and Friends Scale were used to collect the data. Collected data were analyzed using SPSS-16.

Results:

Of the 98 study patients, 52 (53.1%) were female and the remainder were male. Lung cancer constituted the most prevalent type of cancer (25.5%). The mean hopelessness score was 5.93 ± 4.71. The mean scores for social support provided by family and friends were 10.89 ± 5.61 and 14.94 ± 4.16, respectively. Significantly negative correlations were observed between the mean scores of hopelessness and social support provided by family (P = 0.007; r = −0.270) and friends (P = 0.001; r = −0.327).

Conclusion:

According to the findings of the present study, Iranian patients with cancer have relatively mild levels of hopelessness and moderate levels of social support. Perceived social support was also found to affect the patients' hopefulness. Given the lack of studies on this subject, it is recommended that further studies are performed.

Association between abnormal serum free light chains ratio and known prognostic factors in lymphoma; a nephrology viewpoint

Introduction: The serum immunoglobulin free light chain (FLC) assay quantities of free kappa (κ) and lambda (λ) light chains. This assay has prognostic value in plasma cell proliferative disorders. There are limited data on serum FLC in B-cell malignancies.

Objectives: The aim of this study was to compare the known prognostic factors in non-Hodgkin’s lymphoma of the type B-cell and Hodgkin disease with an abnormal secretion amount of light chains in these lymphomas.

Patients and Methods: The association of pretreatment FLC and FLC ratio (κ:λ) with previously known prognostic factors for lymphoma such as the international prognostic index (IPI) and B symptoms were evaluated in 50 patients with Hodgkin’s and non-Hodgkin’s lymphoma. IPI is a prognostic score given based on the clinical variables including age, disease stage, serum LDH and extra-nodal involvement. Elevated FLC and an abnormal κ:λ ratio was defined based on the previous publications.

Results: The prevalence of abnormal FLC ratio was 38% in all patients and 40.9% in patients with diffuse large B-cell lymphoma. Abnormal FLC ratio was significantly associated with IPI (P=0.04) and B symptoms (P=0.02) in both groups of the patients with Hodgkin’s and non-Hodgkin’s lymphoma. The stage of the disease in Hodgkin’s lymphoma patients showed a significant relationship with the abnormal FLC ratio (P=0.04). Presence of the B symptoms in patients with Hodgkin’s lymphoma had a modest but not statistically significant association with the abnormal FLC ratio (P=0.07).

Conclusion: Abnormal FLC ratio as a new potent prognostic biomarker has a significant association with IPI which is the most common clinical tool used to predict outcome in lymphoma patients. Since there is a need for developing a reliable and quantitative prognostic biomarker for lymphoma, evaluation of the independent effect of the abnormal serum FLC ratio is suggested to be considered in future prospective studies. The result of these studies will also be useful for nephrologists, while serum immunoglobulin FLC is capable to damage kidney.

Serological Study on Cytomegalovirus and Toxoplasma Gondii in Thalassemia Major Patients of Yazd, Iran

BACKGROUND

Beta-thalassemia patients receive blood products from blood transfusion centers repeatedly. Blood transfusion can transmit Cytomegalovirus (CMV) and Toxoplasma gondii. The aim of this study was serological evaluation of these two infectious agents in thalassemia patients.

MATERIALS AND METHODS

In a cross-sectional study, the enzyme-linked immunosorbent assay (ELISA) testing was performed to detect IgM and IgG antibodies against CMV and Toxoplasma gondii in 96 thalassemia patients (under 18 years) and 144 healthy people. Data were analyzed by SPSS software and Chi-square test.

RESULTS

A significant difference was observed in CMVIgM antibody levels between test groups in women (p<0.05). The prevalence of CMV IgM, CMV IgG, Toxo-IgG, and Toxo IgM antibodies in thalassemia patients were 5.2%, 95.9%, 16%, and 0%, respectively.

CONCLUSION

In all thalassemia patients, Cytomegalovirus IgG is higher than healthy people. In addition, CMV IgM antibodies are higher in female patients. Antibody screening (IgM) on blood products for detecting Cytomegalovirus is necessary, but for Toxoplasma gondii is not necessary in the Yazd transfusion center.

Trismus Resulting from Infantile Hemangioma of the Parotid: A Rare Case Report

Vascular abnormalities are characterized by increasing number of vessels. Salivary gland tumors are uncommon and their overall incidence is about 3 per 100000 per year. Salivary gland hemangioma makes up 1 % of all salivary gland tumors. Trismus resulting from parotid hemangioma is so rare. The patient was a 6-month-old boy with a huge lesion in his right parotid who referred to Shahid sadoughi hospital of Yazd, Iran. The lesion appeared at 4 months of age and had rapid growth and was suspected as hemangioma after clinical examination and patient had trismus. The lesion was excised without any complications. Five months after surgery, area of the lesion appeared normal. Parotid hemangioma has low potential to turn into malignant form but early detection and biopsy are necessary for decreasing complications. Removal of the mass was the best treatment for the patients with large or complicated hemangioma; however, it should be performed with caution because the tissues may bleed profusely. Patients may have long term survival after surgery.

Giant pedunculated polypoid submucosal lipoma of the splenic flexure of colon: case report and review of the literature

Lipomas of the colon are rare but clinically important conditions that require suitable evaluation for guiding appropriate therapy. The majority of lipomas arise from the submucosal layer in the ascending colon, especially near the ileocecal valve, which causes difficulties in diagnosis. Giant lipomas may be misinterpreted as a premalignant adenomatous polyp, particularly when arising in the left colon. A 38-year-old man presented with manifestations including hypogastric pain, constipation, loss of appetite and weight, accompanied by anaemia, nausea, vomiting and haematochezia. Colonoscopy revealed a large submucosal polyp about 5 x 4 cm, which was located at the splenic flexure of colonic. Surgery detected an oval polypoid tumour measuring 70 x 50 x 45 mm in size, having a pedunculated appearance and a stalk diameter of 20 mm. Histopathologic examination of the biopsy from the lesion confirmed diagnosis of a giant submucosal lipoma. In our experience, most giant colonic lipomas are found to be sessile and occur in the ascending colon in older patients. Herein, we report a pedunculated tumour in a 38-year-old male located in the splenic flexure of colon.

Life skills training effectiveness on non-metastatic breast cancer mental health: a clinical trial

Background:

Patients with breast cancer are predisposed to some psychiatric symptoms and mental disorders due to their life styles or disease conditions. These problems cause patients to deal with daily stress, feeling guilty, anxiety, dysphoric mood, and impaired social relations. Such problems would lead to serious mental disorders.

Objectives:

Therefore, life skills training may help patients to cope better with their condition, and improve their mental health.

Materials and Method:

In an experimental study, 50 patients with breast cancer were selected randomly and assigned to 2 experimental and control groups. The experimental group attended life skills training classes for 10 weeks continuously (each class lasting 2 hours). Participants in both the experimental and control groups completed a GHQ-28 questionnaire form before the commencement of classes, and again after 2 weeks to 2 months of the course completion. T-test was used as the statistical method.

Results:

In life skills training group, depressive and anxiety symptoms, somatization disorders, sleep disorders and disorders of social functioning were significantly decreased (p<0.0001). These changes were not observed in the control group.

Conclusions:

The results showed that life skills training is an effective method in reducing symptoms of depression, anxiety, sleep and somatic disorders. Also, it would be useful in reducing problems of social dysfunction.

Infantile fibrosarcoma in a child: a case report

BACKGROUND

Infantile Fibrosarcoma is a rare soft tissue tumor in infants and children mostly located in extremities. An infantile and adult form has similar histopathological patterns but survival prognosis is much better in infantile form. Recurrence of infantile fibrosarcoma is common but the rates of metastasis are less than 10 percent in children younger than five Years and 50 percent in children more than 10 years old.

CASE PRESENTATION

In this case report, we presented a nine years girl with a relapsing mass in her left hand. The pathologic findings showed sheets of spindle-shaped cells with suggested diagnose of infantile fibrosarcoma. She was successfully treated with combination of surgery and chemotherapy with a good outcome.

CONCLUSION

Infantile fibrosarcoma is a differential diagnose of soft tissue mass in infants and children. It has a good prognosis and distant metastasis is uncommon. Choice of treatment is surgery but chemotherapy and radiotherapy were useful in decrease metastasis.

Accuracy of Sentinel Node Biopsy in Breast Cancer Patients with a High Prevalence of Axillary Metastases

Background:

Sentinel lymph node biopsy (SLNB) has become a standard diagnostic tool for axillary staging of breast cancer and has many advantages in comparison with axillary dissection. The goal of our study was to determine accuracy and predictive value of SLNB for assessing the axillary lymph nodes involvement in breast cancer.

Materials and Methods:

Thirty three patients with breast cancer at Mehr and Taleghani hospitals in Tehran between July 2005 and 2006 were randomly selected. All women underwent presurgical lymphoscintigraphic mapping followed by sentinel node biopsy guided by intraoperative gamma probe and blue dye. Sentinel nodes were examined by standard hematoxylin and eosin (H&E) staining. Among studied patients, T1 stage accounted for 3%% of the patients, T2 for 6%, T3 for 66.7% and T4 for 24.3%. Statistical analyses were performed by evaluating of sensitivity, specificity, accuracy, and positive and negative predictive values of SLNB in comparison to axillary lymph node dissection (ALND).

Results:

The sentinel lymph nodes in 30.3% of patients were well imaged by lymphoscintigraphy. A mean of 4.8 sentinel lymph nodes were removed per patient. Sensitivity and specificity of SLNB were 92% and 87.5%, respectively. Totally, in comparison to ALND, the accuracy of SLNB was 90.9% and false negative rate of this method was also 8%.

Conclusion:

Our experience shows SLNB to be reliable and accurate for axillary staging in breast cancer patients with a high prevalence of axillary metastases and can be replaced diagnostic ALND in our breast cancer centers.