Does thyroid dysfunction happen in CML patients receiving Imatinib for treatment?

Subarachnoid hemorrhage is one of the most important and dangerous neurologic emergencies worldwide. It is characterized by a sudden and severe headache caused most commonly by the rupture of intracranial aneurysm. Cerebral vasospasm is the Chronic myelogenous leukemia is a myeloproliferative disorder presenting with anemia, elevated blood granulocytosis and the presence of immature granulocytes, basophilia, frequently thrombocytosis and spleen enlargement. The diagnosis is stabilized by hematopoietic stem cell expressing a fusion gene [BCR/ABL] resulted from translocation of 9 and 22 chromosomes. The products of this gene play a central role in developing chronic myelogenous leukemia including maintenance of chronicity and/or progress to accelerated phase and or blastic crisis. Imatinib is the first generated tyrosine kinase Inhibitor, which prevents ATP binding to a specific situation of tyrosine kinase molecules that are involved in phosphorylation of membranous proteins and activation of the pathways that are necessary for tumor cell survey and proliferation. Therefore, tyrosine kinase inhibitor inhibits signaling proteins, which are responsible for tumor growth, invasion, angiogenesis and even metastasis. Although tyrosine kinase inhibitor are specific targeted-designed compounds, every agent interacts with many kinds of tyrosine kinases and produces many unwanted effects. One of the undesirable adverse effects is thyroid dysfunction. The first reported article about tyrosine kinase inhibitor-induced thyroid dysfunction published in 2005 and since then few studies have demonstrated thyroid disturbances ranging from subclinical thyroid dysfunctions to overt clinically thyroid disorders during tyrosine kinase inhibitor therapy. This review attends to summarize only imatinib-induced thyroid disturbances in CML patients with positive Philadelphia chromosome in recent years

Frequency of FLT3 ITD and FLT3 TKD mutations in multiple myeloma patients [a case control study]

Background and Aims: multiple myeloma is a malignant proliferation of plasma cells derived from a single clone. The tumor, its products and the host response lead to organ damages. Some factors that are responsible in its pathogenesis are recognized. As FMS like Tyrosine Kinase 3 receptor [FLT3] mutation has been proved as a determining factor in leukemic patients; the goal of this study was to find association of FLT3 internal tandem duplication [ITD] and FLT3 tyrosine kinase domain [TKD] mutations with multiple myeloma

Materials and Methods: this case-control study was conducted on 60 paraffinembedded bone marrow biopsies [30 multiple myeloma and 30 normal bone marrow specimens] in the pathology departments of Ghaem and Imam Reza hospitals in Mashhad. After sections preparation, DNA was extracted and two PCR reactions were set up for detection of FLT3/ ITD and FLT3/TKD mutations

Results: the Mean age of samples was 64+/-10 years. No FLT3 mutations were detected in multiple myeloma patients

Conclusion: our findings showed that occurrence of FLT3 mutations seem unusual in multiple myeloma

[Expression of candida albicans ALS 2 and ALS 9 genes isolated from women with vaginal candidiasis by RT-PCR]

Approximately three-fourths of women experience an episode of vaginal candidiasis. Candida albicans[C. albicans] is the etiological agent in over 80% of cases. C. albicans has numerous virulence factors such as the agglutinin-like sequence [ALS] genes which code the large glycoprotein family that has a role in the adherence of Candida. The present study aims to evaluate expressions of the ALS 2, 9 genes in C. albicans which have been isolated from vaginal candidiasis. We collected 150 wet vaginal swabs from patients diagnosed with vaginal candidiasis. Samples were cultured on sabouraud dextrose and CHROMagar for morphological analysis. Then, DNA was extracted by glass bead and lysis buffer. We performed RFLP-PCR to confirm the presence of C. albicans. For investigation of semiquantitative expression of ALS2 and ALS9 genes, we performed RT-PCR by using specific primers. From 55 clinical isolates of C. albicans, 36.36% expressed both the ALS2 and ALS9 genes. There were 23 [41.81%] isolates that expressed only the ALS2 gene and 21 [38.1%] expressed the ALS9 gene. Expressions of the ALS9 [41.8%] and ALS 2 [38.1%] genes in Candida isolates may indicate that these genes play a critical role in adhesion and biofilm formation of vaginal infection. However the presence of both genes in 36.36% of the isolates suggests a positive role for these genes in augmentation of their activities.

[Evaluation of the relationship between platelet count, mean platelet volume and pulmonary thromboembolism]

Mean platelet volume [MPV] is associated with platelet reactivity. Large platelets contain more thrombogenic factors than small ones. Previous studies have shown platelet reactivity in patients with pulmonary thromboembolism [PTE].The aim of this study was to investigate the mean platelet volume [MPV] and platelet count in patients with PTE and healthy control subjects. In This study, 210 patients with PTE were retrospectively evaluated. The diagnosis of PTE was made clinically and was confirmed with CT angiography. 210 healthy subjects matched for age, gender and body mass index [BMI] served as control group. We recorded the main demographic, clinical and laboratory data of groups. MPV values and platelet counts were measured at the first day of admission. Mean age between PTE patient and control group was 52.6 +/- 19.7 vs. 49.43 +/- 20.68 years respectively [p=0.109] .MPV was significantly higher among patients with PTE in comparison with control group [10.57 +/- 1.08 vs. 9.80 +/- 0.86 fL respectively; p= 0.000]. Platelet count was not significantly different in PTE patients and control group [231.76 +/- 92.22 vs. 243.76 +/- 67.32 x 10 9 /L, respectively; p= 0.129]. MPV is a simple and easy test and it can be used as an activity marker of platelet function in PTE. It also shows the platelet production rate and stimulation. We have shown that MPV was increased in patients with PTE. Platelet count was not different between PTE patients and control group.

IFN-gamma +874 and IL-4 -590 polymorphisms and asthma susceptibility in North West of Iran

Recent studies have documented an association between some cytokines' gene polymorphisms and chronic inflammation of the respiratory tract which leads to asthma susceptibility. This study was conducted to investigate if there were any differences in IFN-gamma +874 [A/T] and IL-4 -590 [C/T] single nucleotide variations in asthmatic patients compared to normal controls among West Azerbaijani population. IFN-gamma +874 [A/T] and IL-4 -590 [C/T] polymorphisms were amplified by ASO-PCR and RFLP-PCR from genomic DNA of 173 individuals including 64 asthmatic patients and 109 control subjects from West Azerbaijani population. The allele or genotype frequencies of IFN-gamma+874 A/T in patients were not different from those of controls [p>0.05]. The differences between allelic or genotypic frequencies of IL-4 -590 C/T in patients and controls were not statistically significant [p>0.05]. These findings showed that IL-4 -590 [C/T] and IFN-gamma+874 [A/T] polymorphisms were not associated with asthma susceptibility

Late onset dysphagia secondary to post-pneumonectomy syndrome, a rare complication

Postpneumonectomy syndrome reflects extrinsic compression of the distal trachea and main stem bronchus due to shifting of the mediastinum and hyperinflation of the remaining lung. The syndrome is characterized by development of progressive dyspnea, cough, inspiratory stridor, and recurrent pneumonia in patients at least 6 months after surgery. We report a case of late onset dysphagia secondary to post-pneumonectomy syndrome, nine years after right pneumonectomy. It is a rare complication and there are only two similar reports in the literature

Tumor-to-tumor metastases from lung carcinoma to soft tissue fibrous histiocytoma

Tumor-to-tumor metastases are uncommon. Lung cancer is the most frequent donor tumor while renal cell carcinoma is the most common malignant, and meningioma the most common benign recipient of metastases. Other reported host benign lesions include thyroid adenoma, adrenocortical adenoma, ovarian cystoma, and hepatic cavernous angioma. A 41-year-old male smoker presented with a mass in the right axillary's fossa, cough and weight loss. Chest x-ray showed left lung collapse. Fiberoptic bronchoscopy showed vegetation in the left main bronchus and biopsy revealed adenocarcinoma. Biopsy of the right axillary mass showed benign fibrous histiocytoma [BFH] with metastasis from adenocarcinoma. To our knowledge, this report represents the first case of tumor-to-tumor metastasis to BFH

Smoking and asthma symptoms among university students

The prevalence of asthma is known to be increasing especially in developed countries. Most studies assessing the prevalence of asthma in adults have used the "European Community Respiratory Health Survey" [ECRHS] protocol. The aims of this study were to determine the prevalence of asthma, asthma-like symptoms and smoking as well as the correlation of asthma symptoms and smoking among Urmia medical university students. An ECRHS questionnaire with additional questions about absence from class because of wheezing and/or dyspnea and smoking was filled for them. One thousand five-hundred students with the mean age of 20.8 +/- 3.5 years filled out the questionnaires. Among them, 17.1% of males and 2.3% of females were current smokers. The most prevalent symptoms during the last 12 months were wheezing [19.7%], resting breathlessness [10.2%], exercise-induced cough [16.5%], and asthma attacks [3.1%]. Asthma symptoms were strongly related to smoking [for all variables p < 0.001] but were not related to sex [p > 0.05], 5.4% had a history of absence from class because of wheezing or dyspnea. We found a relatively high prevalence of wheezing among young adult university students. Our findings suggest that cigarette smoking is common among young university students with asthma symptoms. Adequate public health measures are needed to prevent smoking among Iranian young adults, and medical students should be better educated with regard to asthma and the risks of smoking

Agreement between written and video asthma symptoms questionnaires in school children in Urmia, Iran

The prevalence of asthma remains difficult to determine with precision with no absolute or gold standard for diagnosis. International Study of Asthma and Allergies in Childhood [ISAAC] developed video questionnaire for epidemiological studies with less reliance on understanding written asthma questionnaire. The aim of this research was to determine the agreement between the ISAAC written and video questionnaires [AVQ3.0] on respiratory symptoms and reported asthma. We studied 3000 children aged 13-14 years in Urmia, Iran who completed sequentially the ISAAC written and video questionnaires [AVQ3.0] at school. The agreement between responses to the two questionnaires for reported wheeze ever, current wheeze, wheeze on exercise, and nocturnal wheeze [the latter three questions relating to symptoms in the previous 12 months], and to any combination of the latter three questions was examined by using concordance and kappa coefficients as measures of agreement. The prevalence of wheeze ever, current wheeze, wheeze on exercise, and nocturnal wheeze were significantly lower based on responses to the video questionnaire compared to the written questionnaire. Although concordance between video and written questionnaires was high [75% to 93%] for related questions, agreement measured by the kappa statistic for each question was only poor i.e. 0.22, 0.21, 0.13 for resting wheeze, exercise induced wheeze, and nocturnal wheeze respectively. We conclude that the video questionnaire yields lower reported prevalence rates for asthma symptoms, and that there is poor agreement between responses to the two questionnaires in Iranian children

Thromboprophylaxis practice in teaching hospital settings

Venous thromboembolism [VTE] is known to be a major cause of morbidity and mortality among hospitalized patients. The American College of Chest Physicians [ACCP] published their seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy in 2004, with recommendations for venous thromboembolism prophylaxis. Despite these recommendations, appropriate thrompoprophylaxis is underused. This study was performed to examine the frequency and adequacy of thromboprophylaxis in hospitalized patients in three primary-tertiary teaching hospitals in Urmia, Iran. We carried out a cross-sectional prospective study on 436 patients hospitalized in three teaching hospitals in Urmia, Iran. Information was obtained from medical-nursing records and patient observation and was compared with the recommended guidelines of the ACCP. The appropriateness of diagnoses was not evaluated. Of 436 patients, 352 subjects required thromboprophylaxis and the total proportion of them who underwent some form of thromboprophylaxis was 16.7% with only 9.9% receiving ACCP recommended prophylaxis. Prophylaxis rate was: 29.7% in medical wards, 27.8% in ICU, 11.0% in surgical wards overall and14.7% postoperatively. Low dose heparin was the most common type of prophylaxis. Despite the widely disseminated, evidence-based recommendations, venous thromboembolism prophylaxis is underused in our hospitals. It is more commonly neglected in our hospitals than those in Western countries. We think that in most other developing countries, this condition is similar. Therefore, the consensus statements alone are insufficient to ensure the routine use of prophylactic strategies in clinical practice. In addition to the statements, other strategies are required to solve the problem

Epithelioid hemangioendothelioma: a case with large solitary pulmonary mass and hypertrophic osteoarthropathy

We describe a case of pulmonary epithelioid hemangioendothelioma [PEH], previously known as intravascular bronchoalveolar tumor, in a 48-year-old woman with an initial diagnosis made by CT-guided transthoracic needle biopsy. This is a rare disease, with approximately 50 cases described in the literature. To our knowledge, this has not been previously described in the English-language literature. This tumor can affect multiple organs. PEH is usually multifocal or small sized; hypertrophic osteoarthropathy is uncommon. This patient presented with hypertrophic osteoarthropathy and large solitary pulmonary mass, rare presentations of this uncommon tumor