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Colorectal cancer (CRC) is distinguished by epigenetic elements like DNA methylation, histone modification, histone acetylation and RNA remodeling which is related with genomic instability and tumor initiation. Correspondingly, as a main epigenetic regulation, DNA methylation has an impressive ability in order to be used in CRC targeted therapy. Meaningly, DNA methylation is identified as one of most important epigenetic regulators in gene expression and is considered as a notable potential driver in tumorigenesis and carcinogenesis through gene-silencing of tumor suppressors genes. Abnormal methylation situation, even in the level of promoter regions, does not essentially change the gene expression levels, particularly if the gene was become silenced, leaving the mechanisms of methylation without any response. According to the methylation situation which has a strong eagerness to be highly altered on CpG islands in carcinogenesis and tumorigenesis, considering its epigenetic fluctuations in finding new biomarkers is of great importance. Modifications in DNA methylation pattern and also enrichment of methylated histone signs in the promoter regions of some certain genes like MUTYH, KLF4/6 and WNT1 in different signaling pathways could be a notable key contributors to the upregulation of tumor initiation in CRC. These epigenetic alterations could be employed as a practical diagnostic biomarkers for colorectal cancer. In this review, we will be discuss these fluctuations of MUTYH, KLF4/6 and WNT1 genes in CRC.

Blood clots are one of the leading causes of death as a consequence of cardiovascular disease in the first place. Design and synthesis of new thrombolytic drugs is aimed at the prevention of side effects one of the important target in medicine. Herein, we report a novel nano-composite prepared by Urokinase with magnetite nanoparticles (Fe3O4@MCM-41-Urokinase). The magnetic nano-drug was prepared in three steps: (i) preparation of colloidal iron oxide magnetite nanoparticles (Fe3O4 MNPs) with particle size lower than 8.0 nm, (ii) development of an organic–inorganic MCM-41 mesoporous structure on the surface of MNPs (Fe3O4@MCM-41) and (iii) load the Urokinase on synthesized nano-composite surface (Fe3O4@MCM-41-Urokinase). The prepared organic–inorganic magnetic nano-drug was characterized by FT-IR (Fourier transform infrared spectroscopy), XRF (X-ray fluorescence), XRD (X-ray powder diffraction), TEM (Transmission electron microscopy) and VSM (Vibrating-sample magnetometer). The TEM image show, a large number of magnetite nanoparticles (2–5 nm) are dispersed in the structure of the siliceous mesoporous. shows excellent activity in the drug delivery in rats. The synthesized nano drug showed good stability to environmental factors. The drug delivery was evaluated in a group of 16 rats, the results showed that drug delivery in the presence of a magnetic field was successfully carried out. [ABSTRACT FROM AUTHOR]

Injuries, especially traffic accidents are so important causes of death, disability, hospital expenses, economic damages to the society which World Health Organization selected them as the main subjects for investigation and research. We have done an epidemiologic study about trauma in Guilan, a province in north of Iran. This is a descriptive study carried out on patients with traumatic injuries, admitted in Poursina Teaching Hospital, during September 2005 to July 2006. Data were collected prospectively using a data collection form including demographic information, mechanism of trauma, anatomical site of injuries, according to AIS90 and severity of head trauma according to glasgow coma scale (GCS). Data were processed by SPSS 11.5 and are shown in tables and figures. Overall 3598 patients admitted. Mean age was 31.85 ± 17.76 years with male to female ratio about 3.5:1. Most of patients were 25-44 years old (33.9%). Traffic accidents were the leading cause of injuries (73.84%) and then fall (15.7%). Motorcycle was the most common mode of transport in our patients (47.07%) after that car (24.3%). Occurrence of traffic accidents increased through evening. Forty six percent of patients transported to hospital by people or came themselves (46.42%). Head and neck were the most common injured part of body (82.4 %,) however about in 81.66% of patients were mild and then limb and pelvis (34.7%). Finally about 2.8% of them died. A trauma especially traffic accidents are an important public health issue in Guilan, we recommend conducting other studies focusing on risk factors in details, and considering injury prevention in local decision making.

Surgical approaches to primary hyperparathyroidism (PHPT) have been associated with a change from invasive to non-invasive methods in the last 20 years. In this cross-sectional descriptive study, 55 patients with primary adenoma-induced HPT underwent surgery. The parathyroid gland in patients with primary hyperparathyroidism caused by parathyroid adenoma was removed by open surgery with an incision of about 2 cm in the neck in a targeted manner in a site localized by ultrasound or Sestamibi scan. The patients' personal information, including age, sex, length of hospital stay, serum calcium and parathyroid hormone (PTH) levels, success rate, and problems and unwanted adverse consequences of surgery (e.g. infection and bleeding) were recorded for each patient and collected information was analyzed in SPSS software. Most patients were women (80%) and individuals in the age range of 41-60 years (47.3%). The hospital stay length ranged from 2 to 5 days with an average of 3.25±0.9 days. Success was considered as a decrease in PTH and calcium levels during the first 24 h after the intervention, and success rates of 100, 98.2, and 69.1%, respectively, were evaluated for a reduction of at least 50% in PTH levels and less than 40 ng/ml of PTH levels. No major complications were reported in the studied patients. Wilcoxon test revealed significant decreases in patients' postoperative serum calcium and PTH levels (P=0.000). Mini-incision Parathyroidectomy with limited incision was associated with significant reductions in serum calcium and PTD without complications. [ABSTRACT FROM AUTHOR]

Introduction: In End Stage Renal Disease (ESRD), the patient needs alternative treatments such as dialysis for survival. To perform hemodialysis, proper vascular access is required. At emergency situations, the Central Venous Catheters (CVC) are used; however, they are not ideal for long-term dialysis. Hence, the permanent methods of hemodialysis should be replaced as soon as possible. This study aimed to investigate the causes of delay in the establishment of permanent vascular access in patients undergoing hemodialysis in Guilan in 2014 to 2015. Methods: The study was performed on 420 patients with ESRD who had been undergone hemodialysis through a CVC for more than three weeks in Razi Educational Remedial and Research Center. Data collection was done through checklist and interviews with the patients. All information entered into the SPSS 21 and analyzed by descriptive and inferential tests. Results: Totally, 56.4% of patients were male and 25.5% were 61 to 70 years old. 42.1% had delay between 1 and 2 months. The most important predictors of delay were: Patient's unwillingness, high costs of surgery, patient's inadequate knowledge about the need to establish AVF (Arterio Venous Fistula), Patient's fear of risks of AVF, lack of proper insurance coverage, Old age, Lesions at the insertion site of vascular access and lack of access to a nephrologist. Conclusion: Promoting the patients scientific information about establishing a permanent vascular access can have a significant role in reducing the delays in establishing permanent vascular access. [ABSTRACT FROM AUTHOR]

BACKGROUND: This systematic review is conducted to explore available information on clinical presentations, laboratory finding and outcomes of SARS-COV-2 in liver transplant patients. METHODS: We searched four databases for relevant terms related to COVID-19 and liver transplantation and collected both case reports and case series on liver transplantation published up to the end of September 2020. RESULTS: After initial screening of irrelevant articles, 25 studies were included and analyzed in this review. Among the 59 patients included, 78.3% were over 50 years old, and 71.6% were males. The majority of patients (93.3%) were hospitalized. The most common presenting symptoms were fever (72.9%) followed by dyspnea and cough (54.2%). The majority of patients revealed a high level of CRP (64.3%). Moreover, high level ALT, AST and ALP were reported in 64.3, 37.5, 30.5 and 22.2% of patients. A total, 9(15.3%), of cases died as a result of complications of COVID-19. Chest radiographs were reported in 72.9%(43/59) of cases that 94% demonstrated radiologic evidence of abnormality. CONCLUSION: The results demonstrated that the most prevalent symptoms and signs were fever, dyspnea and cough. Moreover, most patients were males and hospitalized. The rate of mortality and high level of CRP, ALT/AST and ALP is similar within the non-immune suppressed and general population. However, early detection of high level of serum CRP, ALT/AST and ALP combined with a clinical COVID-19 symptom and finding of CT scan may be used as an index for the presence and severity of the disease. [ABSTRACT FROM AUTHOR]

Purpose: End-Stage Renal Disease (ESRD) is a severe form of chronic kidney disease (CKD). Hemodialysis has increased the life expectancy in patients with renal failure. The most common complication of vascular access is thrombosis in lines. Medical interventions such as anti-thrombolytic drugs can be more effective and affordable. In this study, we aimed to evaluate streptokinase efficacy on the success rate and secondary patency rate of thrombosed hemodialysis catheters. Methods: In this prosepective study, 34 dialysis patients with thrombosed permicaths who entered to Razi hospital, were examined. The study population included the hospital during one year and three months. The cases received streptokinase, three times according to protocol. Each of the successful cases had been controlled after three months. After collection, the data were analyzed by SPSS version 21. Results: The frequency of males and females was too close. Findings showed that the Streptokinase was effective in 80 % of patients. And this effect continued for 22.1±18.2 months on average, and more than 70 % of patients' permcaths can be used after 3 months. More than 90% of patients didn't report any allergic reactions, and the allergic reactions have been limited to fever, nausea and back pain. Conclusion: The study showed although the replacement of occluded dialysis catheters is expensive and invasive, using streptokinase is effective and affordable, and is more secure than invasive methods. [ABSTRACT FROM AUTHOR]

Primary simultaneous multiple organs teratomas are extremely rare. They usually arise in the gonads, and only 1–3 % of them arise in the mediastinum. We present a case of simultaneous multiple organs immature teratomas who was admitted to Razi hospital because of cough, dyspnea, and left-side supraclavicular mass. Computed tomography (CT) showed a big mass with multiple high densities, nodular, semi-solid, heterogenic structures on the left side of the neck, left-side anterior mediastinum, right-side middle mediastinum and right-side suprarenal region. CT-guided needle biopsy was performed and histopathological study showed immature teratoma. After performing neoadjuvant therapy, the tumors were removed. The patient underwent chemo radiation therapy on the mediastinum and abdomen. On 6-months follow-up, he was asymptomatic. This case is being reported because of the rarity of multiple organs immature teratomas and informing other clinicians about managing these cases. [ABSTRACT FROM AUTHOR]

Bladder squamous cell carcinoma (SCC) may lead to gross hematuria. However, the metastasis of head and neck cutaneous SCC to the urinary bladder has not been described in literature. Nowadays, noninvasive methods such as embolization, are considered as an appropriate choice for controlling life-threatening hematuria in patients with high operative risk. However, few reports exist on the effectiveness of this approach in managing the hematuria secondary to metastatic bladder SCC. Here we report a case of bladder SCC originating from the forehead cutaneous SCC. An 83-year-old man, a known case of forehead cutaneous SCC with distant metastasis, referred to our clinic with a chief complaint of hematuria. Pathology confirmed the diagnosis of metastatic urinary bladder SCC. Angiography and embolization were undertaken and resulted in complete alleviation of the symptoms. The recurrence of hematuria or embolization-related complications were not observed during 3-month follow-up. Selective embolization of the bilateral internal iliac artery is a safe and efficient procedure for controlling severe hematuria in patients with primary or metastatic bladder SCC. [ABSTRACT FROM AUTHOR]