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Background: This study compared the rate of thromboembolic events during carotid angioplasty and stenting (CAS) with and without embolic protection devices (EPDs). We reviewed literature to find studies comparing embolic event rates during CAS with and without EPDs and conducted a meta-analysis to determine the safer approach. Methods: The Embase, PubMed, and Web of Science databases were thoroughly searched following PRISMA guidelines. Each estimation was executed using random-effects models. The I2 index was used to assess the heterogeneity among the studies. Egger and Begg’s tests were applied to evaluate publication bias. Stata version 14.2 was used for statistical analysis. Results: For 25% of patients, an EPD was used during CAS, and for 75% it was not. Of the patients undergoing CAS, the prevalences of hypertension, diabetes mellitus, coronary artery disease, and cigarette smoking were 81%, 37%, 39% and 43%, respectively. In total, of the patients included 52% were symptomatic and 48% were asymptomatic. The mortality rate reduced from 2% in the no-EPD subgroup to 1% in the EPD subgroup. The occurrence of all other complications was also reportedly higher in patients who did not receive an EPD, including major stroke and myocardial infarction, except for minor events, which were reported to be almost the same in both subgroups. Conclusions: We found that the use of an EPD can help reduce the occurrence of thromboembolic complications of CAS, including myocardial infarction, major stroke, and death. Altogether, our results suggest that the benefits of using an EPD during CAS outweigh its risks.

Helicobacter pylori infection is a well-established risk factor for the development of gastric cancer (GC). Understanding the immunopathogenesis underlying this association is crucial for developing effective preventive and therapeutic strategies. This narrative review comprehensively explores the immunopathogenesis of H. pylori-induced GC by delving into several key aspects, emphasizing the pivotal roles played by H. pylori virulence factors, including cytotoxin-associated gene A (cagA) and vacuolating cytotoxin A (vacA), blood group antigen-binding adhesin (babA), and sialic acid binding adhesin (sabA). Moreover, the review focuses on the role of toll-like receptors (TLRs) and cytokines in the complex interplay between chronic infection and gastric carcinogenesis. Finally, the study examines the association between H. pylori evasion of the innate and adaptive immune response and development of GC. A comprehensive understanding of the immunopathogenesis of H. pylori-induced GC is essential for designing targeted interventions to prevent and manage this disease. Further research is warranted to elucidate the intricate immune responses involved and identify potential therapeutic targets to improve patient outcomes.

Introduction: Keratoacanthoma (KA) and squamous cell carcinoma (SCC) are two cutaneous conditions with morphological resemblance, which can complicate the diagnosis in some cases. Using immunohistochemistry staining of biomarkers could be beneficial in resolving this obstacle. Objectives: we investigated a variety of biomarkers assessed in different studies in order to find the most important and helpful biomarkers for differentiation between SCC and lesions capable of spontaneous regression. Methods: PubMed medical literature and Google Scholar database were used to identify relevant literature up to 15 June 2022. The aim of our analyses was to determine the capability of biomarkers to distinguish SCC from lesions capable of spontaneous regression using calculated individual and pooled OR and 95% CI and I2 tests. Results: Six potential biomarkers are CD10 with pooled OR= 0.006 (95% CI 0.001 to 0.057) and I2=0%; COX-2 with pooled OR=0.089 (95% CI 0.029 to 0.269) and I2=17.1%; Elastic Fibers with pooled OR= 6.69 (95% CI 2.928 to 15.281) and I2=0%; IMP-3 with pooled OR=0.145 (95% CI 0.021 to 1.001) and I2=44.5%; P53 with pooled OR=0.371 (95% CI 0.188 to 0.733) and I2=55.9%; AT1R with OR=0.026 (95% CI 0.006 to 0.107). Conclusions: We suggest the utilization of the following IHC biomarkers for discrimination between lesions with spontaneous regression such as KA and SCC: CD10, COX-2, and Elastic Fibers.

Background: Rheumatoid arthritis (RA) is the most common chronic inflammatory joint disease. Complications of RA can cause low quality of life and disabilities. Nowadays, despite all the medical developments, etiology of RA is unclear. Both soft and hard tissue damages occur in RA and periodontitis due to chronic inflammation and also since tissue damage presentation and pathogenesis of RA and periodontitis are the same, this study was done for evaluating the relationship between clinical and laboratory findings in RA patients with their oral status and disease activity. Methods: This case-control study was performed on 236 patients; 118 RA patients and 118 cases of normal people. Gingivitis, dental caries and plaques, oral hygiene and severity of periodontitis were measured based on gingival index, plaque index, clinical attachment level, Decayed Missing Filled index and oral hygiene index-simplified. Disease activity was assessed according to Diseases Activity Score-28. Blood samples were taken to evaluate the level of anti-CCP, RF, ESR, CRP, and CBC. Data were analyzed by t-test and chi-square. Results: RA patients are more susceptible to periodontitis, plaque formation and dental caries. There is a relationship among RA disease and periodontitis, oral hygiene, gingivitis. There is also a reverse relationship between RF level and periodontitis severity likewise dental caries. There is no significant relationship between other laboratory findings and the oral status of patients. Conclusion: This is more likely for RA patients to experience periodontitis which can destruct alveoli bone and it can also cause early tooth loss. Regular examination and early treatment are highly recommended.

Providing adequate information within a concise documentation format remains a problem in healthcare institutions throughout the United States. A task force was developed at Memorial Sloan-Kettering Cancer Center in New York, NY, to revise the documentation system, including the comprehensive adult patient history and data base (PHDB) form. The new PHDB form consists of a patient or family self-report section and a nursing assessment section. A pilot project using the form was implemented and evaluated. The form was found to be useful and efficient and was recommended for hospital implementation. This article describes the development of this new form and its ongoing monitoring and evaluation.

Lyme disease is a complex multisystem disorder that begins with the bite from the Ixodes tick. The Ixodes tick carries the spirochete, Borrelia burgdorferi, and infects humans with the spirochete. The initial symptoms of Lyme disease are the erythema chronicum migrans, or "bull's eye" rash, and flu-like symptoms. Stage III of Lyme disease can occur weeks to months after the initial infection when more serious complications may develop, such as neurologic, cardiac, or ophthalmologic problems. If Lyme disease goes untreated, arthritic symptoms may occur in stage III. Prompt diagnosis and treatment with antibiotics are of utmost importance for a full recovery. Education and prevention techniques also are needed to decrease the number of people infected by the Ixodes tick.