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Study Design: Systematic review Background : Considering the infiltrative nature of intramedullary astrocytoma, the goal of surgery is to have a better patient related outcome. Objective: To compare the overall survival (OS) and neurologic outcomes of complete vs incomplete surgical resection for patients with intramedullary astrocytoma. Methods: A comprehensive search of MEDLINE, CENTRAL and EMBASE was conducted by two independent reviewers. Individual patient data (IPD) analysis and multivariate Cox Proportional Hazard Model was developed to measure the effect of surgical strategies on OS, post-operative neurological improvement (PNI), and neurological improvement in the last follow up (FNI). Results: We included 1079 patients from 35 studies. Individual patient data of 228 patients (13 articles) was incorporated into the integrative IPD analysis. Kaplan-Meier survival analysis showed complete resection (CR) significantly improved OS in comparison with the incomplete resection (IR) (log-rank test, P =.004). In the multivariate IPD analysis, three prognostic factors had significant effect on the OS: (1) Extent of Resection, (2) pathology grade, and (3) adjuvant therapy. We observed an upward trend in the popularity of chemotherapy, but CR, IR, and radiotherapy had relatively stable trends during three decades. Conclusion: Our study shows that CR can improve OS when compared to IR. Patients with spinal cord astrocytoma undergoing CR had similar PNI and FNI compared to IR. Therefore, CR should be the primary goal of surgery, but intraoperative decisions on the extent of resection should be relied on to prevent neurologic adverse events. Due to significant effect of adjuvant therapy on OS, PNI and FNI, it could be considered as the routine treatment strategy for spinal cord astrocytoma. [ABSTRACT FROM AUTHOR]

Background: Multiple choice questions (MCQs) are the most common questions in clinical tests. Content validity and appropriate structure of the questions are always outstanding issues for each education system. This study aimed to evaluate the role of providing quantitative and qualitative feedback on the quality of faculty members' MCQs. Methods: This analytical study was conductedonKermanshah University of Medical Sciences facultymembersusing the totalMCQs test at least two times from 2018 to 2021. The quantitative data, including the validity of the tests, difficulty, and discrimination indices, were collected using a computer algorithm by experts. Results: The second analysis revealed that 14 (27.5%) faculty members had credit scores below 0.4, which was within the acceptable range for the overall validity of the test. The results showed a higher difficulty index in the second feedback than the first (0.46 ± 0.21 vs 0.55 ± 0.21, P = 0.30). No significant difference was found in the discrimination index (0.24 ± 0.1.25 vs 0.24 ± 0.10, P = 0.006). Furthermore, there were no significant differences in terms of taxonomy I (61.29 ± 20.84 vs 59.32 ± 22.11, P = 0.54), II (29.71 ± 17.84 vs 32.76 ± 18.82 P = 0.39), and III (8.50 ± 16.60 vs 7.36 ± 14.48, P = 0 .44) before and after feedback. Conclusions: Based on the results, the questions were not ideal regarding Bloom's taxonomy standards and the difficulty and discrimination indexes. Furthermore, providing feedback alone is not enough, and proper planning by the educational and medical development centers' authorities is required to empower the faculty members in this area. [ABSTRACT FROM AUTHOR]

Allergic rhinitis (AR) is a T helper type 2 (Th2)-mediated upper airways disease in which genetics factors including cytokine genes play a prominent role. Interleukin-33 (IL-33) is a major cytokine for naive T cells polarization into Th2 phenotype as well as enhances the secretion of Th2 cytokines. The aim of the present study was to investigate the relationship between IL-33 single nucleotide polymorphisms (SNPs) and IL-33 serum level with Allergic rhinitis. Blood samples were collected from 130 AR patients and 130 healthy individuals. SNPs (rs7044343 C > T, rs1929992 A > G, rs12551256 A > G) of IL-33 gene were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Serum level of IL-33 was measured by enzyme-linked immunosorbent assay (ELISA). Statistical analysis showed that the TT genotype (OR = 1.996, CI: 1.168–3.412, P =.01), as well as the T allele (OR = 0.675, CI: 0.476–0.957, P =.02) of rs7044343 C > T were significantly associated with reduced risk of AR. In addition, individuals carrying the TT genotype were associated with lower levels of IL-33 compared to subjects with CC and CT genotypes; however, these differences were not statistically significant. No association was found between rs1929992 and rs12551256 variants and risk of AR, but the GG genotype from rs1929992 A > G was associated with increased serum levels of IL-33 in control group (p =.01). Furthermore, serum IL-33 levels were not significantly different between AR patients and healthy controls (p >.05). Our results suggest that the TT genotype of rs7044343 C > T may act as a protective agent against allergic rhinitis. [ABSTRACT FROM AUTHOR]

Background: Retinoic acid (RA) plays a key role in naïve T cell differentiation into FOXP3+ Treg cell in the respiratory airways. The present study aims to investigate RA and Treg-related cytokine serum levels, salivary IgA levels, FOXP3 and IL-4 gene expression, and the relationships between RA serum levels and Treg-related cytokines in allergic rhinitis (AR) patients and healthy controls. Methods: Salivary IgA and serum IgE, RA, IL-10, and TGF-ß concentrations were measured by ELISA in 37 AR patients and 30 age- and sex-matched healthy controls. Results: IL-10 and TGF-ß concentrations were significantly less in AR patients than in healthy controls (p < 0.01 and P< 0.0001, respectively). Salivary IgA was significantly greater in patients than in controls (p< 0.05). RA was not significantly different between patients and controls (p> 0.05); however, a significant positive correlation was found between serum RA and both IL-10 and TGF-ß in AR patients. Conclusions: Our data suggest that RA may influence AR risk via affecting the TGF-ß and IL-10 production. [ABSTRACT FROM AUTHOR]

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder characterized by neuronal degeneration and inflammation in the nerves. The role of the immune system has been concentrated by researchers in the etiopathogenesis of the disease. Given the inhibitory roles of regulatory T cells (Tregs), it is expected that increasing or activating their populations in patients with ALS can have significant therapeutic effects. Here we searched databases, including CENTRAL, MEDLINE, CINAHL Plus, clinicaltrials.gov, and ICTRP for randomized clinical trials (RCTs) and non‐RCTs until March 2019. For preclinical studies, we searched PubMed, Scopus, and Google Scholar up to June 2019. We also included preclinical studies, due to the lack of clinical information available, which used Tregs (or directly targeting them) for treating mice models of ALS. We identified 29 records (CENTRAL 7, MEDLINE 4, CINAHL Plus 8, and clinicaltrials.gov 10) and removed 10 duplicated publications. After screening, we identified one RCT which had been published as an abstract, three non‐RCTs, and four ongoing studies. We also identified 551 records (PubMed 446, Google Scholar 68, and Scopus 37) for preclinical studies and performed a meta‐analysis. Finally, we found three papers that matched our inclusion criteria for preclinical studies. Results indicated the effectiveness of the application of Tregs in the treatment of ALS. Our meta‐analysis on preclinical studies revealed that Tregs significantly prolonged survival in mice models of ALS. Overall, our analysis testified that exertion of Tregs in the treatment of ALS is a promising approach, that notwithstanding, requires further evaluations. [ABSTRACT FROM AUTHOR]

Asthma and allergic diseases are inflammatory conditions developed by excessive reaction of the immune system against normally harmless environmental substances. Although acute inflammation is necessary to eradicate the damaging agents, shifting to chronic inflammation can be potentially detrimental. Essential fatty‐acids‐derived immunoresolvents, namely, lipoxins, resolvins, protectins, and maresins, are anti‐inflammatory compounds that are believed to have protective and beneficial effects in inflammatory disorders, including asthma and allergies. Accordingly, impaired biosynthesis and defective production of immunoresolvents could be involved in the development of chronic inflammation. In this review, recent evidence on the anti‐inflam]matory effects of immunoresolvents, their enzymatic biosynthesis routes, as well as their receptors are discussed. Asthma and allergic diseases are inflammatory conditions developed by excessive reaction of the immune system against normally harmless environmental substances. Essential fatty‐acids‐derived immunoresolvents, namely, lipoxins, resolvins, protectins, and maresins are anti‐inflammatory compounds that are believed to have protective and beneficial effects in inflammatory disorders, including asthma and allergies. [ABSTRACT FROM AUTHOR]

Objective: Allergic rhinitis is defined as a chronic mucosal inflammation in nasal tissues. Lipoxin A4 (LXA) is well-Known as a specialized pro-resolving lipid mediator for prevent excessive inflammation and tissue homeostasis. The aim of this study was to evaluate the serum levels of lipoxin A4 (LXA4) in patients with allergic rhinitis. Material and Methods: Peripheral blood was obtained from 37 patients with allergic rhinitis (confirmed by prick test) and 20 age- and sex-matched control cases. Serum levels of lipoxin A4 were quantified by ELISA. Results: The results indicated that the mean serum levels of LXA4 were significantly lower in allergic rhinitis group compared with the control group (P<0.05). Conclusion: These results suggested that lower serum levels of LXA4 might lead to an increased susceptibility to chronic inflammation in nasal mucus of patients with allergic rhinitis, suggesting a potentially novel therapeutic approach to upper chronic airway inflammation [ABSTRACT FROM AUTHOR]

Background: Interleukin-10 (IL-10) is an anti-inflammatory cytokine whose levels are elevated in patients with severe COVID-19. IL-10 polymorphisms may play a role in increasing IL-10 levels and the severity of COVID-19. This study aimed to investigate the relationship between IL-10 single nucleotide polymorphisms (SNPs) (rs1800896 [-1082 C < T], rs1800871 [-819 A > G], and rs1800872 [-592 T > G]) and the severity of COVID-19 in patients from Kermanshah Province, Iran. Methods: A total of 150 patients with mild COVID-19 (84 men and 66 women aged 40.1 ± 12.44 years) and 143 patients with severe COVID-19 (76 men and 67 women aged 61.04 ± 15.65 years) participated in this study. Blood samples were collected from the patients, DNA was extracted, and the genotype of each SNPs was determined using the polymerase chain reaction-restriction fragment length polymorphism method. Result: The results of this study did not show a significant relationship between the genotypes of the three studied SNPs and the severity of COVID-19 ( p > 0.05). Conclusion: According to our findings, these SNPs were not associated with COVID-19 severity in patients in Kermanshah.

Background: Chronic inflammation is associated with many inflammatory diseases. Specialized pro-resolving mediators (SPMs) are well known for their crucial role in promoting the resolution phase of inflammation and restoring tissue homeostasis. Resolvin D1 (RvD1) is an endogenous omega-3-derived lipid mediator with pro-resolving activity. This study aimed to evaluate the effect of Resolvin D1 (RvD1) on some inflammatory miRNAs (mir-155-5p, miR146a-5p and miR148-3p) and Krüppel-like factors 5 (KLF5) in an LPS-stimulated THP-1 preclinical model of inflammation., Methods: PMA-differentiated THP-1 cells (macrophages) were pre-incubated with or without various concentrations of RvD1 (10, 50, or 100 nM) for 2 h prior to stimulation by 1 μg/ml LPS. Un-stimulated PMA-differentiated THP-1 cells were as the control group. Then, the expression levels of target genes were evaluated by real-time PCR., Results: Compared with untreated macrophages, stimulation with 1 µg/ml LPS increased mRNA expression levels of TNF-α, KLF5, miR-155-5p, miR-146-5p, and miR-148a-3p. When the cells were exposed to various concentrations (10, 50 and 100 nM) of RvD1 for 2 h prior to LPS stimulation, the TNF-α, KLF5, miR-155-5p, miR-146-5p, and miR-148a-3p mRNA expression levels were significantly downregulated in a dose-dependent manner, compared to the LPS group., Conclusions: The results demonstrate that RvD1 can attenuate inflammatory response in LPS-stimulated macrophages. Our data also showed that RvD1 may exert anti-inflammatory effects by inhibiting miR-155-5p, miR-146a-5p, and miR-148-3p., Competing Interests: The authors declare that they have no conflicts of interest regarding this manuscript.

Purpose: To describe the variance of inner, middle, and outer retinal layer thicknesses (IRT, MRT, and ORT) at the macular area in children and adolescents with normal eyes in different age groups., Methods: This cross-sectional study enrolled subjects aged 5-18 years with normal eyes. The macula was scanned by optical coherence tomography (6 mm × 6 mm AngioScan-Optovue). Four age groups were defined (≤7, 7-10, 11-14, and ≥14 years). The influences of age and gender were analyzed., Results: One hundred and thirty-nine eyes of 69 subjects with a mean age of 10.92 ± 3.51 years were registered. The mean whole macular thickness (MT) was 297.32 ± 11.05 in males and 303.197 ± 13.32 in females ( P = 0.01, t -test). The MT in each aging group was 301.47 ± 2.5, 295.53 ± 1.71, 300.81 ± 2.12, and 298.6 ± 1.87, subsequently ( P = 0.17, analysis of variance test). Significant differences were found between the sexes at the perifoveal area and mainly in IRT. No correlation between eyes was noted. We observed that the RT fluctuates during growth and that gender has some influence on the evolution of RT. IRT and MRT changed reciprocally in all macular areas, whereas ORT expanded in all age groups of children and adolescents., Conclusions: No subsegmental retinal thickness difference between eyes was observed in pediatric groups in this study, while gender had some influence on perifoveal IRT. Despite the fact that this study is not a longitudinal study, we can get some insight into the developmental changes in retinal thickness and its clinical applications in children and adolescents., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Current Ophthalmology.)

Background: It is not yet known which types of Toll-like receptors (TLRs) are most effective in Helicobacter pylori (H. pylori) recognition. It is also not known which gastric zones have the most prominent roles in TLR-mediated bacterial recognition. The aim of this work was to analyze the expression of TLR2 and TLR4 in biopsy specimens from H. pylori-infected patients., Methods: Thirty-eight patients with gastrointestinal disorders were divided into four groups in this study. The groups were: (A) H. pylori infection and peptic ulcer (n=15), (B) peptic ulcer only (n=5), (C) H. pylori infection only (n=10) and (D) control, with neither H. pylori infection nor peptic ulcer (n=8). Biopsy specimens from sites of redness or atrophic mucosa from gastric antrum and body in patients with gastritis were collected. RNAs from the antrum and body specimens were isolated. TLR2 and TLR4 mRNA expression was assessed by RT-PCR and quantified as densitometric ratios of TLR2 and TLR4/β-actin mRNA., Results: In the antral zones of H. pylori-infected patients (Groups A and C) TLR2 and TLR4 expression was significantly greater than in uninfected patients (Groups B and D) regardless of peptic ulcers (p < 0.05). In the gastric body samples TLR2 expression was significantly greater in Group C (H. pylori infection only) than in Group B (peptic ulcer only) and TLR4 expression was significantly greater in group A (H. pylori infection and peptic ulcer) than in Group B (peptic ulcer only) (p < 0.05). No significant differences in expression of TLR4 and TLR2 were observed between samples from the antrum and body in same groups., Conclusions: We conclude that H. pylori infection leads to significant increase in TLR2 and TLR4 molecules expression in antral region related to the control group. Considering the stimulatory effect of H. pylori on TLRs expression in the gastric tissue, we assume that colonization of H. pylori infection might occurs more in the gastric antral region than in the gastric body.