The most common allergens according to skin prick test: The role of wheal diameter in clinical relevancy

The skin prick test (SPT) could be applied as a useful in vivo method for the detection of sensitization in epidemiological and diagnostic studies if the wheal size is ideally evaluated. We focused on SPT wheal size to identify sensitization pattern to common inhalant and food allergens. In this cross‐sectional study, SPT results were obtained from a total of 972 allergic patients. Common allergen extracts for SPT were selected according to the type of allergic diseases, and the geographical pattern. SPT with food allergens was performed for patients with atopic dermatitis (AD) and chronic urticaria (CU). A total of 461 male (47.4%) and 511 female (52.6%) participated in this study (median age: 31 years). The majority of individuals were affected with allergic rhinitis (AR) (n = 624) and asthma (n = 224); while 129 and 67 patients suffered from AD and CU, respectively. The most common aeroallergens were Russian thistle (52.1%) and lamb's quarter (50.7%) with the largest wheal diameter. The wheal size of lamb's quarter was significantly different between patients with asthma and AR (P<.001). In addition, a significant difference was detected in wheal diameter in response to the Russian thistle between patients with AR and AD (P = .001). Shrimp (23.6%) and Peanut (22.5%) caused the most common food sensitization in patients with AD and CU. Having in mind the most common weed pollens including the Russian thistle and lamb's quarter, preventive strategies, such as, removing unwanted weeds or preventing them from growing, avoidance, and specific immunotherapy may be crucial for better disease control.     

Hereditary risk factors for the development of gastric cancer in younger patients

Background  

It is believed that the development of gastric cancer (GC) before the age of 50 has a hereditary basis. Blood group A and history of gastric cancer in first-degree relatives have been shown to be risk factors for GC.     

Investigating Association of Three Polymorphisms of Coagulation Factor XIII and Recurrent Pregnancy Loss

Citation Jeddi‐Tehrani M, Torabi R, Mohammadzadeh A, Arefi S, Keramatipour M, Zeraati H, Zarnani AH, Akhondi MM, Mahmoudian J, Mahmoudi AR, Zarei S. Investigating association of three polymorphisms of coagulation factor XIII and recurrent pregnancy loss. Am J Reprod Immunol 2010; 64: 212–217 Problem Among important suspected causes of thrombophilia in women with recurrent pregnancy loss (RPL) are the polymorphisms of coagulation factor XIII (FXIII) gene. We performed a case–control study on the association between three polymorphisms of factor XIII (FXIII G103T, FXIII A614T and FXIII C1694T) and RPL in Iranian women. Method of study DNA samples from peripheral blood of 100 female patients with at least two recurrent abortions, as case group, and 100 healthy women with history of at least two successful deliveries were subjected to PCR‐RFLP, and the frequencies of the polymorphisms were calculated and compared between the two groups. Results The prevalence of FXIII G103T polymorphism was 29% in the case group and 17% in the control group (P = 0.158). The frequencies of FXIII A614T and FXIII C1694T were 84% and 66% in the case group and 48% and 31% in the control group (P < 0.001 and P < 0.001), respectively. The two latter polymorphisms are associated with RPL in Iranian women and increase the risk of RPL. A correlation was also found between FXIII A614T and FXIII C1694T polymorphisms (P < 0.001). Conclusion We suggest the evaluation of FXIII A614T and FXIII C1694T polymorphisms in women with RPL.     

A single-arm open-label clinical trial of autologous epidermal cell transplantation for stable vitiligo: A 30-month follow-up

Background

Recently, we introduced intralesional injection of autologous epidermal cells as a safe and feasible approach for transplantation in patients with stable vitiligo. This approach resulted in less pain during and after the procedure, no scarring or cobblestone formation at the recipient site, and was more feasible to perform on curved surfaces such as joints, lips, eyelids, ears, and face.

Suicide-related interpersonal needs of young Iranian people: A preliminary validation of thwarted belongingness and perceived burdensomeness constructs

The aim of the current study was to validate the Interpersonal Needs Questionnaire (INQ-15) and to test its reliability in Persian-speaking Iranian undergraduate students. In this cross-sectional study, 485 undergraduate students (age: 20.66 ± 1.42, 60% female) were assessed on the two subscales of perceived burdensomeness (PB) and thwarted belongingness (TB) and the Suicide Behavior Questionnaire-Revised (SBQ-R). Exploratory structural equation modelling (ESEM) confirmed the construct validity of INQ-14, excluding INQ#9. In addition, INQ#8, articulated in an equivalent Persian phrasing, loaded well on TB. The measurement model tested by confirmatory factor analysis (CFA) suggested INQ#11 to be eliminated, resulting in INQ-13-P to consist of PB and TB-7. The internal consistency and convergent/discriminant validity were established. The concurrent validity of PB was solidly established in terms of past year suicidal ideation (PY-SI) above and beyond anxiety, depression, prior suicidality, and TB-7. The effect of PB on PY-SI was stronger, where prior suicidality had already occurred or the perceived likelihood of future suicide (PLFS) was high. Moreover, TB-7 could only indicate PY-SI, where prior suicidality had already occurred or PLFS was high, albeit when PB was omitted. The interaction term was significant; however, beyond anxiety and depression, the effect of TB-7 on PY-SI was significant where PB was very high (n = 40, 8.25%). Therefore, future studies can utilize INQ-13-P as a valid and reliable instrument in Persian-speaking populations. However, further studies should examine the construct validity of TB and its relationship with suicide ideation in different populations.     

Transduction‐Specific ATLAS Reveals a Cohort of Highly Active L1 Retrotransposons in Human Populations

Long INterspersed Element‐1 (LINE‐1 or L1) retrotransposons are the only autonomously active transposable elements in the human genome. The average human genome contains ～80–100 active L1s, but only a subset of these L1s are highly active or ‘hot’. Human L1s are closely related in sequence, making it difficult to decipher progenitor/offspring relationships using traditional phylogenetic methods. However, L1 mRNAs can sometimes bypass their own polyadenylation signal and instead utilize fortuitous polyadenylation signals in 3′ flanking genomic DNA. Retrotransposition of the resultant mRNAs then results in lineage specific sequence “tags” (i.e., 3′ transductions) that mark the descendants of active L1 progenitors. Here, we developed a method (Transduction‐Specific Amplification Typing of L1 Active Subfamilies or TS‐ATLAS) that exploits L1 3′ transductions to identify active L1 lineages in a genome‐wide context. TS‐ATLAS enabled the characterization of a putative active progenitor of one L1 lineage that includes the disease causing L1 insertion L1_RP, and the identification of new retrotransposition events within two other “hot” L1 lineages. Intriguingly, the analysis of the newly discovered transduction lineage members suggests that L1 polyadenylation, even within a lineage, is highly stochastic. Thus, TS‐ATLAS provides a new tool to explore the dynamics of L1 lineage evolution and retrotransposon biology.     

Genome evolution during progression to breast cancer

Cancer evolution involves cycles of genomic damage, epigenetic deregulation, and increased cellular proliferation that eventually culminate in the carcinoma phenotype. Early neoplasias, which are often found concurrently with carcinomas and are histologically distinguishable from normal breast tissue, are less advanced in phenotype than carcinomas and are thought to represent precursor stages. To elucidate their role in cancer evolution we performed comparative whole-genome sequencing of early neoplasias, matched normal tissue, and carcinomas from six patients, for a total of 31 samples. By using somatic mutations as lineage markers we built trees that relate the tissue samples within each patient. On the basis of these lineage trees we inferred the order, timing, and rates of genomic events. In four out of six cases, an early neoplasia and the carcinoma share a mutated common ancestor with recurring aneuploidies, and in all six cases evolution accelerated in the carcinoma lineage. Transition spectra of somatic mutations are stable and consistent across cases, suggesting that accumulation of somatic mutations is a result of increased ancestral cell division rather than specific mutational mechanisms. In contrast to highly advanced tumors that are the focus of much of the current cancer genome sequencing, neither the early neoplasia genomes nor the carcinomas are enriched with potentially functional somatic point mutations. Aneuploidies that occur in common ancestors of neoplastic and tumor cells are the earliest events that affect a large number of genes and may predispose breast tissue to eventual development of invasive carcinoma.The cells of a multicellular organism are related to one another by a bifurcating lineage tree whose root is the zygote. DNA replication, chromosome segregation, and cell division during development from the zygote to the adult introduces point mutations and other DNA changes into the genome, which persist in the descendants of the cells in which they occurred. Germ-line point mutations occur at a rate of approximately one per diploid genome per cell division (Kong et al. 2012), but the rate of somatic changes is less well-understood, and is likely to vary by tissue type. Large-scale genomic changes such as aneuploidies are generally thought to be extremely rare in normal tissue.Cancers, in contrast to normal tissue, accumulate much larger numbers of genomic changes, as illustrated by genome sequencing of late-stage tumors (Ley et al. 2008; Stratton et al. 2009; Bignell et al. 2010; Pleasance et al. 2010a; Chapman et al. 2011; Stratton 2011; Banerji et al. 2012; Nik-Zainal et al. 2012a,b). Solid tumors are highly mutated by several mechanisms, such as point mutations, copy-number variations, and chromothripsis (Greenman et al. 2007; Leary et al. 2008; Beroukhim et al. 2010; Liu et al. 2011; Meyerson and Pellman 2011; Stephens et al. 2011; Crasta et al. 2012; Maher and Wilson 2012); relapses or metastases exhibit further mutational evolution (Ding et al. 2010, 2012; Yachida et al. 2010; Navin et al. 2011; Mardis 2012; Turajlic et al. 2012; Walter et al. 2012; Wu et al. 2012). The state of an individual advanced cancer genome sheds little light on the order of genomic changes, however, except in analyses of subclone evolution (Nik-Zainal at al. 2012a; Shah et al. 2012). In an advanced tumor, the earliest driver changes that had predisposed ancestral cells to eventual carcinoma development are confounded with later changes. As a consequence, our understanding of early tumor evolution is still in its infancy.The historically proven approach to understanding evolution is comparative analysis of extant species, whose power was greatly increased by whole-genome sequencing in recent years. Analogous to species comparisons, which are based on evolutionary (bifurcating) lineage trees, comparisons of somatic genomes from a single individual could, in principle, shed light on somatic evolution, but in normal tissue the number of mutations is low. However, given the large number of genomic changes during tumor evolution, it may be possible to dissect the evolutionary history of a cancer by comparing its genome to clinically recognized precursor lesions. In this context, breast cancers provide a proof-of-principle opportunity, due to their frequent association with early neoplastic lesions that are readily identified by morphology (Simpson et al. 2005; Abdel-Fatah et al. 2007; Lopez-Garcia et al. 2010; Bombonati and Sgroi 2011), and whose genomes may provide windows into the earliest stages of tumor evolution.Using whole-genome sequencing of histologically characterized archival (formalin-fixed, paraffin-embedded) samples, we determine lineage relationships of early neoplasias with carcinomas, quantify mutational load and mutation spectra during progression from normal tissue to neoplasia to carcinoma, and find the earliest detectable mutations and aneuploidies in cell lineages ancestral to the lesions. A subset of these early events may have provided the initial oncogenic potential and helped trigger the first clonal expansion. Our analyses reveal variation among the six cases in the specific evolution of neoplasia and tumor, as would be expected for an evolutionary process dominated by stochasticity. The mechanistic commonalities among the cases, however, bear significant implications for our conceptualization of tumor origins and progression.     

Quality Assessment of Services in Primary Healthcare in Iran: A Systematic Review and Meta-analysis

BackgroundPrimary healthcare (PHC) plays an important role in achieving universal health coverage (UHC). The SERVQUAL instrument is the tool for evaluating the quality of services in the health sector. The main purpose of this study is to evaluate the quality of services provided in PHC in Iran using the SERVQUAL instrument.Materials and MethodWe searched eight databases from January 2000 to September 2021. We analyzed the mean of various SERVQUAL instrument items using the DerSimonian-Laird approach via a random model with 95% confidence interval. Also, we used I2 to evaluate the heterogeneity of the studies.ResultsFinally, 17 studies were chosen for analysis in the present study. There were 8,767 study participants, out of which 8,237 were female and 530 were male. The mean dimensions of perception were as follows: Tangibles = 3.71, reliability = 4, responsiveness = 3.79, assurance = 3.83, and empathy = 3.86. For the expectation, the mean dimension were: Tangibles = 4.46, reliability = 4.46, responsiveness = 4.36, assurance = 4.36, and empathy = 4.36 respectively. The total gap quality between perception and expectation was -0.53.ConclusionAll dimensions of quality based on SERVQUAL were negative, and the quality of service in PHC is not satisfactory. Therefore, policymakers must adopt serious and effective programs to improve services in this area. We also recommend that quality management of services in PHC in Iran should move toward comprehensive optimization in all areas, and quality in this area should be a priority.