Non-Hodgkin’s lymphoma (NHL) is a cancer that starts in the lymphatic system. In NHL, the important part of the immune system, a type of white blood cells called lymphocytes become cancerous. NHL ...subtypes include marginal zone lymphoma, small lymphocytic lymphoma, follicular lymphoma (FL), and lymphoplasmacytic lymphoma. The disease can emerge in either aggressive or indolent form. 5-year survival duration after diagnosis is poor among patients with aggressive/relapsing form of NHL. Therefore, it is necessary to understand the molecular mechanisms of pathogenesis involved in NHL establishment and progression. In the next step, we can develop innovative therapies for NHL based on our knowledge in signaling pathways, surface antigens, and tumor milieu of NHL. In the recent few decades, several treatment solutions of NHL mainly based on targeted/directed therapies have been evaluated. These approaches include B-cell receptor (BCR) signaling inhibitors, immunomodulatory agents, monoclonal antibodies (mAbs), epigenetic modulators, Bcl-2 inhibitors, checkpoint inhibitors, and T-cell therapy. In recent years, methods based on T cell immunotherapy have been considered as a novel promising anti-cancer strategy in the treatment of various types of cancers, and particularly in blood cancers. These methods could significantly increase the capacity of the immune system to induce durable anti-cancer responses in patients with chemotherapy-resistant lymphoma. One of the promising therapy methods involved in the triumph of immunotherapy is the chimeric antigen receptor (CAR) T cells with dramatically improved killing activity against tumor cells. The CAR-T cell-based anti-cancer therapy targeting a pan–B-cell marker, CD19 is recently approved by the US Food and Drug Administration (FDA) for the treatment of chemotherapy-resistant B-cell NHL. In this review, we will discuss the structure, molecular mechanisms, results of clinical trials, and the toxicity of CAR-T cell-based therapies. Also, we will criticize the clinical aspects, the treatment considerations, and the challenges and possible drawbacks of the application of CAR-T cells in the treatment of NHL.
•Hypothermia can have potential side effects for patients with cardiac surgery.•Rewarming is effective in improving some hemodynamic parameters.•Rewarming can be used safely to improve the patients’ ...hemodynamic parameters after open-heart surgery.
Hypothermia after open-heart surgery can have potential side effects for patients.
This study aimed to examine the effects of rewarming on patients' hemodynamic and arterial blood gases parameters after open-heart surgery.
This randomized controlled trial was performed in 2019 on 80 patients undergoing open-heart surgery at Tehran Heart Center, Iran. The subjects were consecutively recruited and randomly assigned to an intervention group (n=40) and a control group (n=40). After the surgery, the intervention group was warmed with an electric warming mattress while the control group warmed using a simple hospital blanket. The hemodynamic parameters of the two groups were measured 6 times and arterial blood gas was measured 3 times. Data were analyzed by independent samples t and Chi-squared tests, and repeated measures analysis.
Before the intervention, the two groups did not significantly differ in terms of hemodynamic and blood gas parameters. However, the two groups were significantly different in the mean heart rate, systolic blood pressure, diastolic blood pressure, mean arterial blood pressure, temperature, right and left lung drainage in the first half-hour, and the first to fourth hours after the intervention (p < 0.05). Furthermore, there was a significant difference between the mean arterial oxygen pressure of the two groups during and after rewarming (P <0.05).
Rewarming of patients after open-heart surgery can significantly affect hemodynamic and arterial blood gas parameters. Therefore, rewarming methods can be used safely to improve the patients’ hemodynamic parameters after open-heart surgery.
Sodium caseinate composite films containing lipids–oleic acid (OA), stearic acid (SA), or Matricaria recutita essential oil (MEO) – were prepared through emulsification and their physical, thermal, ...mechanical, and barrier properties were evaluated and compared. Furthermore, their antimicrobial effectiveness against Listeria monocytogenes, Staphylococcus aureus, and Escherichia coli was studied. Emulsified films were softer, less rigid, and more stretchable than pure films. The films’ water vapor barrier properties were found to decrease upon the addition of lipid content; this effect was greatly reduced when MEO was added. The presence of OA/SA and MEO decreased tensile strength and elastic modulus but increased the elongation at break. Thermal analysis of all emulsified films showed two endothermic peaks; these results confirmed those obtained by SEM studies, where a partial separation of the two phases occurred. The films’ antimicrobial activities were increased by incorporating lipids, particularly those containing MEO, which were more effective against the studied bacteria. This work showed that when taking all the studied variables into account, films formulated with MEO were found most suitable for various food applications.
High concentrations of adenosine and interleukin (IL)-6 in the tumor microenvironment have been identified as one of the leading causes of cancer growth. Thus, we decided to inhibit the growth of ...cancer cells by inhibiting the production of adenosine and IL-6 in the tumor environment at the same time. For this purpose, we used chitosan-lactate-PEG-TAT (CLP-TAT) nanoparticles (NPs) loaded with siRNA molecules against CD73, an adenosine-producing enzyme, and IL-6. Proper physicochemical properties of the produced NPs led to high cell uptake and suppression of target molecules. Administration of these NPs to tumor-bearing mice (4T1 and CT26 models) greatly reduced the size of the tumor and increased the survival of the mice, which was accompanied by an increase in anti-tumor T lymphocyte responses. These findings suggest that combination therapy using siRNA-loaded CLP-TAT NPs against CD73 and IL-6 molecules could be an effective treatment strategy against cancer that needs further study.
Combined inhibition of IL-6 and CD73 suppresses cancer growth. Activation of the IL-6/CD73 signaling pathway in cancer cells is correlated with malignant phenotype and poor prognosis. Suppressing of CD73/IL-6 axis using siRNA encapsulated with CLP-TAT NPs could significantly reduce the expression of target molecules. CD73 and IL-6 knockdown could also suppress the proliferative and invasive features of cancer cells by decreasing the expression of ki67(proliferation) and MMP2/9 (metastasis) genes. Display omitted
Performance and lifetime of wireless sensor networks are tightly linked to the used routing protocol. Energy and memory efficiency are some of the main challenges of routing protocols. These ...challenges are more strict in large scale and dense networks. Numerous amount of routing approaches are published so far, emphasized on energy consumption. However, a few of them addresses the limitations of node memory. This paper introduces a new routing protocol called Bloom filter based routing protocol (BFRP). It reduces memory consumption by replacing a routing table with a Bloom filter. Since the approach is devised for clustered networks, a new clustering algorithm is introduced that takes remaining energy into the account for cluster head election. It also supports networks with churn. Several scenarios are simulated with NS2 and the results are compared to Coverage Preservation Clustering Protocol and Hybrid Energy-efficient Distributed Clustering algorithms. The results approve that
BFRP
improves energy consumption and show a significant decrease in memory usage.
In this cross-sectional population-based study, we used the baseline data of the Prospective Epidemiologic Research Studies in IrAN cohort study collected in Iran from 2014 to 2020. The main outcomes ...were the prevalence of hypertension and proportion of awareness, treatment, and control based on the 2017 ACC/AHA guideline compared to the seventh report of the Joint National Committee (JNC7). Of the total of 163,770 participants, aged 35-70 years, 55.2% were female. The sex-age standardized prevalence of hypertension was 22.3% (95% CI 20.6, 24.1) based on the JNC7 guideline and 36.5% (31.1, 41.8) based on the ACC/AHA guideline. A total of 24,312 participants 14.1% (10.1, 18.1) were newly diagnosed based on the ACC/AHA guideline. Compared to adults diagnosed with hypertension based on the JNC7 guideline, the newly diagnosed participants were mainly young literate males who had low levels of risk factors and were free from conventional comorbidities of hypertension. About 30.7% (25.9, 35.4) of them (4.3% of the entire population) were eligible for pharmacologic intervention based on the ACC/AHA guideline. Implementation of the new guideline may impose additional burden on health systems. However, early detection and management of elevated blood pressure may reduce the ultimate burden of hypertension in Iran.
Isfahan Antibiotic Resistance Surveillance System-1 has been instituted in Isfahan, Iran to construct a project for surveillance of clinically significant bacteria, and to help raise a logic regional ...stewardship program for prevention and control of disseminating-resistant organisms.
During March 2016 to March 2018, an antibiotic resistance surveillance system was designed and implemented by Isfahan Infectious Diseases and Tropical Medicine Research Center. The surveillance program was implemented in three general hospitals in Isfahan. In addition to the routine microbiology data, clinical data (differentiation between true infections and contamination, healthcare-associated infections (HCAI) and community-acquired infections (CAI), as well as determination of the infection site) were obtained and analyzed by WHONET software.
During a 2-year period, from 7056 samples that revealed growth of bacteria, 3632 (51.5%) isolates were detected as contamination and 3424 (48.5%) true bacterial isolates were identified. Of these, about 32% of isolates were recognized as HCAI. Totally, the most recognized infections were urinary tract infection, bloodstream infection and skin and soft tissue infections. In patients with HCAIs, 70% of isolates were gram negative and in patients with CAIs 73% isolates were gram negative bacteria.
The strength of the project is gathering enough clinical information in addition to microbiologic data, which would increase application of the results for empiric treatment and prevention of the infectious diseases in clinical settings.
Background: The Global Burden of Disease (GBD) Study provides estimates of deaths, years of life lost (YLL), years of life lived with disability (YLD), and disability-adjusted life years (DALYs) due ...to 249 causes of death, 315 diseases and injuries, and 79 behavioral, environmental, occupational, and metabolic risk factors in 195 countries, territories, and regions by sex and 20 age categories in 195 countries and regions since 1990. In this study, we aimed to present the burden of road traffic injuries (RTIs) in Iran and 15 surrounding countries in 1990–2016. Methods: The standard Cause of Death Ensemble modeling (CODEm) is used to estimate deaths due to all causes of injury by age, sex, country and year. A range of 27 causes is used for estimating non-fatal health outcomes based on inpatient and outpatient datasets using DisMod-MR 2.0. Disability-adjusted life years (DALYs) estimate quantify the total burden of years lost due to premature death or disability and was computed by summing the fatal burden and non-fatal burden associated with a cause (i.e., YLL+YLD). Results: In 2016, age-standardized transport injuries in Iran accounted for 35.6 (UI: 29.64–43.44) deaths per 100000 compared to 60.8 (UI: 51.04–72.49) in 1990. Transport injury became the fourth leading cause of death in Iran in 2016, up from the 5th leading cause of death in 1990. The burden of RTIs was mainly caused by motor vehicles and motorcycles and mostly affected the economically productive age groups (15–49), males and children, especially those at school age. Afghanistan with 59.14 deaths (52.09–66.8) and UAE with 53.71 deaths (36.59–72.77) had the largest transport injury death rates per 100000. From 1990 to 2016, Iran had -2.06 annual percent change in transport death rates. The lowest annual percent change is reported for Turkmenistan at -3.43. While Pakistan, UAE and Qatar had the highest annual percent change in transport injury. Across all countries, the observed-to-expected ratios for transport injury death rates varied considerably in 2016.The UAE had the largest age-standardized ratios of observed-to-expected rate (2.93), followed by Oman (2.39), Saudi Arabia (2.23), Afghanistan (2.04) and Iran (1.95). Conclusions: RTIs continue to be a public health burden in Iran and its neighboring countries, even though, there is evidence for decline in RTIs across all countries except Pakistan. The most frequent sub-causes of death and injury are the motor vehicle, motorcycle, and pedestrian injuries. The most vulnerable road users are children and young adults.
A 27-year-old Iranian, previously healthy male presented with sub-cutaneous necrotic lesions with a localized dermatosis affecting the anterior chest, neck and face. These lesions consisted of ...singular, well-defined verrucous plaques which gradually developed and disseminated over time. The dermatosis was followed by the development of necrotic swollen lesions localized on the hard palate. The patient did not recall any history of trauma or puncture at any of the sites of infection. While histopathological examination of periodic acid-Schiff (PAS) stained material revealed irregular, unbranched, septate hyphae, direct examination (KOH 10%) of lesion samples demonstrated the presence of septate indistinct brownish hyphae. Alternaria malorum was isolated (CBS 126589) and its identity was confirmed by sequencing of the internal transcribed spacer (ITS rDNA). Since the palate lesion reoccurred after 10 years and the patient's condition did not improve with amphotericin B combination therapy, the lesion was surgical excised and he underwent antifungal therapy with amphotericin B and itraconazole. There was no dehiscence or fistula formation or any evidence of relapse of fungal infection during a one year follow-up and the patient was successfully cured. In vitro antifungal susceptibility tests revealed that the MIC values for those antifungals employed in this case were amphotericin B (0.125 μg/ml), fluconazole (32 μg/ml), itraconazole (0.125 μg/ml), voriconazole (1 μg/ml), and posaconazole (0.063 μg/ml). The MECs for caspofungin and anidulafungin were 0.25 μg/ml and 0.016 μg/ml, respectively. However, treatment of A. malorum infections with the latter agents remains to be evaluated.
PDF
