The sociological basis of the skin cancer epidemic.

Given the precipitous rise in its incidence in recent decades, skin cancer has been recognized as a growing epidemic. We explore the sociological underpinnings of this epidemic, including: (1) aging of the demographic; (2) human ecologic factors (residing in areas with high ambient ultraviolet levels and a depleted ozone layer); (3) large-scale European migration to more equatorial latitudes; (4) social structures that for centuries minimized miscegenation and maximized segregation; (5) gender-based differences in sunbathing, tanning, sunscreen use, and clothing choice; (6) occupational ultraviolet exposure; (7) the complex interplay of socioeconomic status, race, and urbanization on skin cancer incidence and mortality; (8) the effects of war on skin cancer incidence; (9) cultural shifts in clothing, travel, outdoor sports, recreation, and attitudes towards being tan; and (10) the indirect effects of religion. We show that without these sociological factors, the most common type of cancer would not be nearly as common.

SARS-CoV-2 and Guillain-Barré Syndrome: Lessons from Viral Infections.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is responsible for the COVID-19 pandemic. COVID-19 has a broad clinical spectrum from asymptomatic patients to multiorgan dysfunction and septic shock. Most of the common symptoms of COVID-19 are classified as respiratory disorders, but some reports show neurological involvements. During the COVID-19 pandemic, a case series of neurological complications, such as Guillain-Barré syndrome (GBS), were reported. GBS is a neuroimmune disorder with acute inflammatory radicular polyneuropathy in different parts of the peripheral nerve. Some studies have reported GBS as an inflammatory neuropathy related to various viral infections, such as cytomegalovirus (CMV), Epstein-Barr Virus (EBV), herpes simplex virus (HSV), human immunodeficiency virus (HIV), influenza, and Zika virus. There are some immunomodulation approaches for the management of GBS. Studies have evaluated the effects of the various therapeutic approaches, including intravenous immunoglobulin (IVIG), plasma exchange (PE), complement inhibitors, and corticosteroids to regulate overactivation of immune responses during GBS in experimental and clinical studies. In this regard, the possible association between GBS and SARS-CoV-2 infection during the outbreak of the current pandemic and also the mentioned therapeutic approaches were reviewed.

Monocytes and macrophages in COVID-19: Friends and foes.

The COVID-19 is a novel infectious disease caused by SARS-CoV-2 and is known as a pandemic emergency that has led to a high rate of mortality throughout the world. Evidence has indicated that hyperinflammatory responses triggered by SARS-CoV-2 are the main cause of pathogenicity in the severe cases of patients who have died during the current viral disease. Monocytes and macrophages as the most important cells of the innate arm of the immune system play a substantial part in the body's defense against viral infections. They mainly respond to the microbial antigens by producing inflammatory mediators to remove pathogens and repair tissue injury. Nevertheless, aberrant alterations in their function such as cytokine storm can be so harmful to the host in the acute respiratory distress syndrome cases caused by SARS-CoV-2. Moreover, inflammatory responses stimulated by SARS-CoV-2 have affected the other vital organs of the body including the heart. As cardiovascular complications in COVID-19 patients have been reported in several studies. During the infection, monocytes and macrophages may be involved in the hypersensitive and exacerbated reactions that contribute to the tissue damage, especially lung injury resulted in its dysfunction and respiratory disorder. In this review, we discuss both advantageous and disadvantageous about the pathological potential of monocytes and macrophages during the infection of SARS-CoV-2 to clarify their mutual effects on immune processing as a fist line defender in the current disease.

The Trend of ripk1/ripk3 and mlkl Mediated Necroptosis Pathway in Patients with Different Stages of Prostate Cancer as Promising Progression Biomarkers.

BACKGROUND: Programmed cell death is critical to maintain tissue homeostasis. Necroptosis, as well as apoptosis, has been considered as another form of regulated cell death which can be used as an effective way to overcome apoptosis-resistant tumor tissue growth. The aim of present study was to test whether or not ripk1, ripk3, or mlkl expression levels, as the key necroptotic modulators in different stages of prostate tumor growth. METHODS: Sixty-seven prostate tissues representing histologically confirmed cancer were selected. The cancer samples were categorized into 4 different stages based on cellular differentiation, tumor growth rate, and extra tissue expansion to regional lymph nodes, average PSA levels, and tumor volume. RNA extraction, cDNA synthesis and quantitative real time PCR were done based on standard guidelines. RESULTS: No statistically significant changes in ripk1 expression showed in all three stages (stage II to IV). The expression pattern of ripk3 represented a remarkable elevation in early stage, while, predominantly repressed in final cancer stage (IV). Also, there has been a significant negative correlation between ripk3 gene expression and tumor size and PSA levels. CONCLUSIONS: We cannot exclude the importance of the key regulator proteins in development and progression of prevalent lethal disease like prostate cancer. The ripk1/ripk3 mediated necroptosis pathway is more activated in early stages of prostate cancer via induced ripk3 expression, while repressed during prostate cancer final stages. Also, the repression of ripk3 is related to elevation of both PSA levels and tumor volume which represented the tumor progression in final stages.

Differentiation of human umbilical cord mesenchymal stem cell into germ-like cell under effect of co-culture with testicular cell tissue.

Supplements produced by mouse testicular cells (mTCs) and the interaction between cells can increase the differentiation rate of human umbilical cord mesenchymal stem cells (hUCMSCs) into the germ-like cells. We studied the differentiation rate of hUCMSCs into the germ-like cells under effect of mTCs co-culturing. Isolated hUCMSCs from postpartum human umbilical cords were cultured. Then, the expression of mesenchymal (CD73, CD90 and CD105) and haematopoietic (CD34 and CD45) markers of hUCMSCs were confirmed by flow cytometry. Then, the hUCMSCs were cultured in four distinct groups: (a) control, (b) co-culture until D0, (c) co-culture until D5 and (d) co-culture until D10, in order to differentiate into the germ-like cells. After 10 days, the expression of OCT4, VASA, Fragilis and SYCP3 genes were examined by Real-Time qPCR. The flow cytometry indicated a high expression of mesenchymal markers and a low expression of haematopoietic markers (CD73:98.6%, CD90: 99.1%, CD105: 99.5%, CD34: 4.22% and CD45: 2.54%). The expression of OCT4 decreased during the time while the expression of VASA, Fragilis and SYCP3 markers increased in the co-culture with testicular cells (p value <.05). Co-culture with mTCs may be used as an effective method to differentiate hUCMSCs into germ-like cells.

Overexpression of the Long Non-Coding RNA NeSt and FOXCUT in Early Stages of Prostate Cancer Samples as Promising Biomarkers.

BACKGROUND: Prostate cancer is one of the most common cancers in males worldwide. Recently, it is well characterized that long non-coding RNAs (lncRNA) play critical roles in the initiation, development, and progression of prostate cancer. NeST, an intergenic lncRNA, was found to be a positive regulator of the pro-inflammatory cytokine, IFN-É£, which is responsible for both antitumor immunity properties as well as tumor evasion. FOXCUT, an-other lncRNA, is mainly a regulator of transcription factor, FOXC1 that is believed to be involved in tumor development and progression. METHODS: In a case-control study, 66 paraffin-embedded prostate tissues representing 36 pathologically confirmed cancer and 30 control samples were examined. The cancer samples were classified in a total of three stages based on PSA levels, tumor volume, and Gleason score. RNA extraction was performed for quantitative determination of IFN-É£, lncRNA NeSt, and lncRNA FOXCUT gene expression in both case and control prostate tissues. RESULTS: Our results showed that NeST lncRNA was significantly up-regulated in prostate cancer samples compared to control, while NeST lncRNA and IFN-É£ gene expression was detected mainly in early stages of prostate cancer. The patients with higher NeST and FOXCUT expression had poor clinical features including PSA levels and tumor volume comparing those with lower expression. Moreover, there was a strong correlation between lncRNA FOXCUT and IFN-É£ expression. CONCLUSIONS: Our data suggests that lncRNA NeST and lncRNA FOXCUT may be able to be introduced as novel molecules involved in prostate cancer development and may provide a potential prognostic biomarker and therapeutic target.

Does motivational interviewing improve the weight management process in adolescents? Protocol for a systematic review and meta-analysis.

BACKGROUND: Data on the effects of motivational interviewing (MI) on modifying unhealthy lifestyles and promoting weight status during childhood is controversial. Adolescents are more prone to assume higher personal responsibilities for behavioral changes. This study aims to investigate whether MI will improve weight management process in adolescents. METHODS/DESIGN: A systematic review will be conducted on clinical trials, assessing the effect of MI on weight management processes in adolescents, aged 10 to 19 years. The primary objective is to assess the efficacy of MI in controlling weight-related measures in overweight and obese adolescents. Secondary objectives are assessing the efficacy of MI on obesity-related behaviors and cognitive abilities considering heterogeneity in outcomes of primary studies in different MI settings. Main data sources include MEDLINE/PubMed, Scopus, Embase, Web of Science, Cochrane, and PsycINFO from 1980 to May, 2018, with no language restrictions. Study selection, data extraction, and risk of bias assessment will be performed by two independent reviewers. A meta-analysis will be conducted on relevant outcomes. Data will be analyzed for outcome of interest using the 95% confidence interval (CI) of an estimate for dichotomous outcomes and mean differences (MDs) for continious outcomes. Cochrane's Q statistic and the I2 statistic will be performed to evaluate the heterogeneity. Subgroup analysis and suitable analytical strategies will be conducted to identify the potential sources of heterogeneity. As we expect a high heterogeneity in our included studies, pooled risk ratios (RRs) and 95% CI will be calculated to estimate the overall effect sizes, using meta-regression models or finite mixture modeling through conducting random effect methods. GRADE system will be used to evaluate the certainty of evidence. We will also use subgroup analysis and the GRADE system to investigate the effect of methodological quality of primary studies on results of meta-analysis. Funnel plots and egger and beggs test and plot will be implemented to assess publication bias. DISCUSSION: The results of this systematic review will provide more insights regarding the effect of MI on weight management in adolescents and will be useful for future research and health promotion programs in this age group. SYSTEMATIC REVIEW REGISTRATION: PROSPERO 2017:CRD42017069813.

Long-term effects of back extensor strengthening exercises on quality of life in women with osteoporosis.

The aim of the present study was to evaluate the long-term effect of back extensor strengthening exercises on health-related quality of life (QOL) in women with osteoporosis. In this randomized clinical trial, 183 women with osteoporosis were treated with pharmacotherapy and weight-bearing and balance-training exercises. The case group additionally performed back extensor exercises at home. Patients filled out the Persian version of the Short Form (SF-36) QOL questionnaire at baseline and 6 months post treatment. At the end, all physical and mental parameters of the SF-36 questionnaire improved significantly in the case group, except for one subscale of mental health, compared to the control group. In the control group, only some physical health dimensions (bodily pain, role limitation, physical function, vitality), and mental health status as a mental health subscale improved. In conclusion, considering a major impact of back extensor exercises on improving QOL in women with osteoporosis over the long term, these exercises should be prescribed in routine management of these patients.

Long acting propranolol and HSP-70 rich tumor lysate reduce tumor growth and enhance immune response against fibrosarcoma in Balb/c mice.

BACKGROUND: Noradrenaline (NA), the principal neurotransmitter released from sympathetic nerve terminals, influences T-cell maturation, not only directly in developing T cells, but also indirectly, by acting on the thymic nonlymphoid cells. In vitro and in vivo studies have demonstrated the anti-proliferative, anti-migratory, anti-angiogenic and cytotoxic properties of propranolol, ß-AR blocker, against various cancers. OBJECTIVES: To evaluate the effect of propranolol on efficacy of HSP-70 rich lysate vaccine in immunotherapy of fibrosarcoma. METHODS: Mouse fibrosarcoma WEHI-164 cells were used to immunize tumor-bearing mice with or without propranolol and HSP-70. Splenocytes proliferation, cytotoxicity activity of the splenocytes, naturally occurring CD4+ CD25high T-reg cells and IFN-γ and IL-4 secretion as well as tumor size, were assessed to describe the anti-tumor immune response. RESULTS: A significant increase in the level of IFN-γ in the mice vaccinated with WEHI-164 cells enriched with HSP-70 and co-treated with propranolol was observed compared to controls. However, HSP enrichment or propranolol treatment alone did not enhance the immune response as measured by the level of IFN-γ. Likewise, a decrease in tumor growth in the test group (p<0.01) and a significant increase in CTL activity (p<0.05) was observed. CONCLUSION: HSP enriched vaccine shows anti-tumor activity, probably due to the modulation of immune responses.

Isolation and characterization of Leucine dehydrogenase from a thermophilic Citrobacter freundii JK-91strain Isolated from Jask Port.

BACKGROUND AND OBJECTIVES: Leucine dehydrogenase (LeuDH; EC 1.4.1.9) belongs to the amino acid dehydrogenase family and isused as a biocatalyst in medical and pharmaceutical industries (1). This study reported deals with the isolation and characterization of LeuDH from a thermophilic bacterium isolated from Jask Port in the Province of Hormozgan. MATERIALS AND METHODS: Aliquots of soil and water samples were cultured in LEU specific medium and thermophilc bacteria that exhibited LeuDH activity were isolated and characterized biochemically. The LeuDH was purified and characterized in regard to the effects of pH and temperature on the activity, as well as its molecular weight determination. RESULTS: A thermophilic bacterium, Citrobacter freundii strain JK-9 was identified and found to exhibit LeuDH activity. The enzyme characterization revealed that LeuDH exhibits higher activity at temperature range of 60 to 75°C (optimum of 60°C) and an optimum pH of activity at pH 10.5. The K m value of LeuDH is 1.2 mM, while its molecular weight is about 320 kDa, and consisted of eight subunits identical in molecular mass (40 kDa). CONCLUSION: Briefly, a thermostableLeuDH enzyme from a strain of C. freundii was isolated and characterized. Our data indicate that the C. freundii enzyme has potential for use in biotechnological applications.

Neurocognitive impairment after off-pump and on-pump coronary artery bypass graft surgery - an Iranian experience.

BACKGROUND: Coronary artery bypass graft (CABG) surgery is one of the most commonly performed surgical procedures worldwide, and it may be accompanied by postoperative neurocognitive impairment. Although this complication has been attributed to the use of cardiopulmonary bypass, it is still a matter of debate whether the switch from on-pump to off-pump technique affects the cognitive function. OBJECTIVE: The aim of this study was to compare the impact of the on-pump and off-pump techniques on neurocognitive impairment in low-risk CABG surgery groups. METHODS: In a descriptive and analytic study, 201 CABG patients with left-ventricular ejection fraction >30%, and without cardiac arrhythmia were enrolled. Before the elective operation, all patients underwent neurological examination and neurocognitive test, Mini-Mental State Examination (MMSE). Two months following the operation, both on- and off-pump, the patients were re-examined by MMSE to detect any neurocognitive impairment. RESULTS: Out of 154 patients included in the study, 95 (61.6%) and 59 (38.3%) patients were in off-pump and on-pump groups, respectively. Mean age of the patients was 57.17 ± 9.82 years. A 2-month postoperative neurocognitive impairment was detected among 17 patients of on-pump group (28.8%) and in 28 cases of off-pump group (29.4%) (P = 0.54). The mean postoperative MMSE scores were not comparable between groups (25.01 ± 4.49 in off-pump group versus 23.73 ± 4.88 in on-pump group, P = 0.09). CONCLUSION: The present study revealed that in low-risk patients undergoing CABG surgery, either the techniques of on-pump or off-pump did not differ regarding the neurocognitive outcome 2 months after the procedure.

Mediastinitis after cardiac surgery in Madani Heart Center, Tabriz, Iran.

Post-sternotomy infections are a kind of nosocomial infection involving the mediastinum space and the sternum, with a high morbidity and mortality rate. The present study was carried out to identify the incidence of mediastinitis following cardiac surgery and the most common risk factors. Cardic patients undergoing surgery were studied for suspicious mediastinitis infection at the Madani Heart Center, Tabriz, Iran from 2004 to 2006. The most common isolated agents included the coagulase-negative staphylococci, Staphylococcus aureus, Pseudomonas aeruginosa and Enterobacter spp. Incidence of postoperative mediastinitis after cardiac surgery was 1.2%. The mortality rate of postoperative mediastinitis was high (34.3%). Wound infection, especially mediastinitis following cardiac surgery, is rare but could be life-threatening. The most important step in the management of wound infections is prevention, and preventive measures could be strengthened by identifying the risk factors.