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The incidence of early‐onset colorectal cancer (CRC), which affects people under 50, is increasing for unknown reasons. Additionally, no underlying genetic cause is found in 20%–30% of patients suspected of having familial CRC syndrome. Whole exome sequencing (WES) has generated evidence for new genes associated with CRC susceptibility, but many patients remain undiagnosed. This study applied WES in five early‐onset CRC patients from three unrelated families to identify novel genetic variants that could be linked to rapid disease development. Furthermore, the candidate variants were validated using Sanger sequencing. Two heterozygote variations, c.1077‐2A>G and c.199G>A, were found in the MSH2 and the MLH1 genes, respectively. Sanger sequencing analysis confirmed that these (likely) pathogenic mutations segregated in all the affected families' members. In addition, we identified a rare heterozygote variant (c.175C>T) with suspected pathogenic potential in the MAP3K1 gene; formally the variant is of uncertain significance (VUS). Our findings support the hypothesis that CRC onset may be oligogenic and molecularly heterogeneous. Larger and more robust studies are needed to understand the genetic basis of early‐onset CRC development, combined with novel functional analyses and omics approaches. [ABSTRACT FROM AUTHOR]

Background: Pain control and adherence to treatment is one of the most common problems in dialysis patients. Psychological treatments can be effective in reducing the problems of these patients. This study attempted to investigate the effectiveness of acceptance and commitment therapy (ACT) on pain control and adherence to treatment among dialysis patients. Methods: It was a semi-experimental pre-test, post-test study with a control group. The statistical population consisted of 40 people who were referred to a dialysis clinic in 2022 and an available sampling method was used to select and randomly assign patients to two experimental and control groups. In the experimental group, ACT was performed in eight sessions of 90 minutes. McGill pain questionnaire (MPQ) and adherence to treatment scale were used. Data were analyzed using SPSS software, version 21 and analysis of covariance. Results: There was a significant difference between the mean scores of pain control and adherence to treatment in the two experimental and control groups (P<0.05). The effect of this treatment on increasing the pain control score was 51% and on increasing the adherence to treatment score was 44%. Conclusion: ACT can increase pain control and adherence to treatment in dialysis patients; thus, it can be used in designing treatment plans for dialysis patients. [ABSTRACT FROM AUTHOR]

Infection with the SARS-CoV-2 virus causes coronavirus disease 2019 (COVID-19). COVID-19 usually affects the lungs but may also involve other organs such as the heart. We report a case of a para-cardiac mass in a previously healthy 45-year-old male who developed persistent dyspnea following SARS-CoV-2 infection. The patient underwent cardiac surgery since the mass was attached to the pericardium and was causing constrictive pericarditis. The pathology report indicated an inflammatory pattern for the mass. Based on the authors' knowledge there has been no previous report of developing a para-cardiac inflammatory mass after SARS-CoV-2 infection. This report aimed to increase awareness regarding the possibility of developing a para-cardiac inflammatory mass following COVID-19. [ABSTRACT FROM AUTHOR]

Colorectal cancer (CRC) is considered one of the most prevalent cancers among Iranian men and women (1). Colorectal polyps, known as precursors of CRCs, are of great importance. Surveillance, locating, and removal of colorectal polyps make them the most modifiable factor apart from other genetic and environmental factors leading to CRCs. Colorectal polyps are defined as outpouchings from superficial and deep layers of mucosa of the colonic wall. They are classified as adenomas, serrated polyps, hyperplastic polyps, and hamartomas based on histological evaluation. Submucosal invasion precludes the possibility of endoscopic resection and should be ruled out via colonoscopic evaluation (2). Knowing this significance, the present study aims to present a brief review on classification, probability of endoscopic resection, complications of endoscopic polypectomy, as well as proper surveillance after polypectomy. [ABSTRACT FROM AUTHOR]

Background: The receptors, ligands, and associated proteins of the insulin-like growth factor (IGF) family are involved in cancer development. The IGF1 receptor and its accompanying signaling cascade are a crucial growth-regulatory mechanism that plays an important role in colorectal cancer (CRC) proliferation and differentiation. IRS1 (Insulin receptor substrate-1), a major substrate for the IGF1R, is involved in cell growth and promotes tumorigenesis. There are shreds of evidence from prior research suggesting that IGF system polymorphisms may influence susceptibility to CRC. However, the findings in this area were contradictory. Accordingly, we carried out a systematic literature search to identify all case-control, cross-sectional, and cohort studies on the association between various polymorphisms across four IGF1 pathway genes (IGF1, IGF1R, IRS1, and IRS2) and the risk of CRC. Methods: We performed a comprehensive search strategy in PubMed, Scopus, and Web of Science databases for articles available until Aug 30, 2022. A total of 26 eligible studies with IGF1/IGF1R, IRS1 and IRS2 polymorphisms; met the inclusion criteria. All case-control studies for IGF1 rs6214C>T, IRS1 rs1801278G>A, and IRS2 rs1805097G>A comprising 22,084 cases and 29,212 controls were included in the current meta-analysis. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were used to evaluate relationships between the polymorphisms and CRC susceptibility. All statistical analyses were performed using STATA software version 14.0. Results: The meta-analysis of available data for rs6214C>T, rs1801278G>A, and rs1805097G>A showed a significant association between these polymorphisms and an increased CRC risk in some of the comparisons studied (rs6214C>T, pooled OR for CC = 0.43, 95% CI 0.21-0.87, P = 0.019; rs1801278G>A, OR for GA = 0.74, 95% CI 0.58-0.94, P = 0.016; rs1805097G>A, OR for GA = 0.83, 95% CI 0.71-0.96, P = 0.013). Nevertheless, the meta-analysis did not include other genetic variations in IGF1, IGF1R, IRS1, and IRS2 due to heterogeneity and limited sample size. Conclusions: This systematic review and meta-analysis provide evidence that genetic variants in IGF1 rs6214C>T, IRS1 rs1801278G>A, and IRS2 rs1805097G>A are associated with an increased risk of CRC. These findings may contribute to a better understanding of the complex genetic mechanisms involved in CRC development and could inform future research on prevention and treatment strategies for this disease. [ABSTRACT FROM AUTHOR]

Background and Aim: Rhodotorula mucilaginosa (R. mucilaginosa) has emerged as a potential pathogen in immunosuppressed hosts. This fungal agent rarely causes onychomycosis in immunocompetent hosts. In this study, onychomycosis caused by this strain on different fingernails and toenails in an Immunocompetent young adult is reported. Case Report: The patient was an 18-year-old woman with clinical symptoms of powdery, hyperkeratosis brief around erythema in the distal part of a toenail and deformity with a groove on surface of a fingernail who was referred to the Medical Mycology Laboratory of Hazrat Ghaem therapeutic center. After diagnostic procedures, he was treated with oral itraconazole 200 mg/day for 2 months along with topical clotrimazole and sulfacetamide ointment and was cured. The nails responded satisfactorily to the treatment. After two months of stopping the drug, the absence of fungus elements in the clinical samples was confirmed. Diagnosis and identification of the fungus was confirmed by morphological characteristics, culture, and DNA molecular method, and R. mucilaginosa was reported as the etiological agent of onychomycosis. Antifungal drug susceptibility was determined in laboratory using the disk diffusion method according to CLSI guidelines. Conclusion: The isolated species was reported as an unusual species of onychomycosis, which needs to be considered by mycology laboratory and clinical specialists for its sensitivity to ketoconazole, itraconazole, and econazole and its resistance to amphotericin B and nystatin. [ABSTRACT FROM AUTHOR]

Conflicting family relationships in childhood lead to poor health in adulthood and can be a risk factor for diseases. Pelvic Floor Dysfunction (PFD) is one of the functional diseases that can originate from psychological conditions. This study compared children's perceptions of parental conflict, self-differentiation and triangulation in patients with PFD type of functional constipation and non-infected counterparts. Results indicated the rate of parental conflict and triangulation is high in PFD patients and they have low self-differentiation. These results could help design therapeutic protocols to accelerate the treatment of PFD, and the use of psychological therapies in addition to drug therapies. [ABSTRACT FROM AUTHOR]

Background: Gallstone disease (GSD) and its complications are major public health issues globally. Although many community-based studies had addressed the risk factors for GSD, little is known about the associations between dietary factors and risk of disease. The present study aimed to investigate the potential associations between dietary fibers with the risk of gallstone disease. Methods: In this case–control study, 189 GSD patients with less than one month of diagnosis and 342 age‑matched controls were enrolled. Dietary intakes were assessed using a 168-item semi-quantitative validated food frequency questionnaire. Crude and multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated through cox proportional hazards regression models. Results: Comparing the highest versus the lowest tertile, significant reverse associations were observed between odds of GSD and each category of dietary fiber intake including total (OR T3 vs. T1 = 0.44, 95% CI: 0.37–0.7, P for trend = 0.015), soluble (OR T3 vs. T1 = 0.51, 95% CI: 0.3–0.8, P for trend = 0.048) and insoluble (OR T3 vs. T1 = 0.56, 95% CI: 0.3–0.9, P for trend < 0.001). The relationship between dietary fiber intake and the risk of gallstones was more prominent in overweight and obese subjects than in subjects with a normal body mass index. Conclusion: Comprehensive assessment of the associations of dietary fiber intake with GSD showed that higher intakes of dietary fiber were significantly associated with reduced GSD risk. [ABSTRACT FROM AUTHOR]