Rhinocerebral mucormycosis,risk factors and the type of oral manifestations in patients referred to a University Hospital in Tabriz,Iran 2007‐2017

Inadequate data are available on the global epidemiology of mucormycosis, mainly derived from the evaluation of specific population groups. Rhinocerebral mucormycosis is an invading and fatal mycosis, particularly among diabetic patients. In the present study, patients hospitalised in Imam Reza Hospital in Tabriz, from 2007 to 2017, were evaluated. The hospital information system (HIS) was used to collect the records of the patients. A total of 42 patients with a diagnosis of mucormycosis were included in the study, 40 cases (95%) of which had a diagnosis of the rhinocerebral form. Of these 40 patients, 21 (52.5%) and 19 (47.5%) were male and female, respectively. Seven cases (17.5%) of rhinocerebral mucormycosis were due to dental procedures. The most predisposing factor in the patients was diabetes with 36 (90%) cases. In our study, the role of tooth extraction in patients with uncontrolled diabetes was identified as an important factor. It may show the important role of dentists in preventing of the disease in diabetic patients.     

Radiation necrosis of the brain after radiosurgery for vestibular schwannoma

OBJECTIVE: The objective of this study was to obtain a better understanding of radiation-induced brain necrosis after stereotactic radiation therapy for vestibular schwannomas. STUDY DESIGN: We conducted a retrospective case analysis. SETTING: The study took place at a tertiary referral center. PATIENTS: We report on the case of a patient treated with stereotactic radiation who developed radiation-induced necrosis of the ipsilateral temporal lobe. INTERVENTION: The various interventions in patients with radiation-induced necrosis include steroid treatment, decompression, and hyperbaric oxygen therapy; these are discussed briefly in this article. Owing to the limited symptoms in our patient, she was observed. MAIN OUTCOME MEASURE: The outcome measure that we evaluated was radiation-induced necrosis of the brain after stereotactic radiation therapy for a vestibular schwannoma. RESULTS: Patients who undergo stereotactic radiation therapy for vestibular schwannomas are at risk for radiation-induced brain necrosis. CONCLUSION: We support the development of a national database that would track the long-term complications of stereotactic radiation therapy to help patients make a more informed decision for the treatment of their vestibular schwannomas.     

Functional changes of the coronary microvasculature with aging regarding glucose tolerance,energy metabolism,and oxidative stress

This study was aimed at characterizing the functional progression of the endothelial (ECs) and smooth muscle cells (SMCs) of the coronary microvasculature between youth and old age, as well as at determining the mechanisms of the observed changes on the basis of the glucose tolerance, mitochondrial energy metabolism, and oxidative stress. Male rats were divided into four age groups (3, 6, 11, and 17 months for the young (Y), young adult (YA), middle-aged (MA), and old (O) animals). The cardiac mechanical function, endothelial-dependent dilatation (EDD) and endothelial-independent dilatation (EID) of the coronary microvasculature were determined in a Langendorff preparation. The mitochondrial respiration and H₂O₂ production were evaluated and completed by ex vivo measurements of oxidative stress. EDD progressively decreased from youth to old age. The relaxation properties of the SMCs, although high in the Y rats, decreased drastically between youth and young adulthood and stabilized thereafter, paralleling the reduction of mitochondrial oxidative phosphorylation. The ECs dilatation activity, low at youth, was stimulated in YA animals and returned to their initial level at middle age. That parameter followed faithfully the progression of the amount of active cardiac endothelial nitric oxide synthase and whole body glucose intolerance. In conclusion, the progressive decrease in EDD occurring with aging is due to different functional behaviors of the ECs and SMCs, which appear to be associated with the systemic glucose intolerance and cardiac energy metabolism.     

Matrix metalloproteinase-2 functional promoter polymorphism G1575A is associated with elevated circulatory MMP-2 levels and increased risk of cardiovascular disease in systemic lupus erythematosus patients

Matrix metalloproteinase-2 (MMP-2) is a zinc dependent endonuclease that degrades type IV collagen, the major structural component of basement membranes. MMP-2 functional promoter polymorphism G1575A affects circulating level of MMP-2 and may be considered an important genetic determinant of cardiovascular disease (CVD) in systemic lupus erythematosus (SLE) patients. In this study, association between MMP-2 1575A allele with serum MMP-2, neopterin and lipid-lipoprotein levels and with SLE and developing CVD was investigated. The present case-control study consisted of 109 SLE patients with and without CVD (mean age, 35.6 years) and 101 gender- and age-matched, unrelated, healthy controls (mean age, 37.1 years) from the population in the west of Iran. MMP-2 1575G/A polymorphism was detected by polymerase chain reaction (restriction fragment length polymorphism) PCR-RFLP, serum MMP-2, neopterin and lipid levels were determined by enzyme-linked immunosorbent assay (ELISA), high-performance liquid chromatography (HPLC) and enzyme assay, respectively. The presence of MMP-2 G1575A allele was found to be associated with SLE and developed CVD (OR?=?1.78, p?=?0.029 and OR?=?3.43, p?=?0.025, respectively). The SLE patients with MMP-2 A (G/A?+?A/A) allele had higher MMP-2 activity (301?±?166 vs. 194?±?35.5, p?=?0.002), neopterin (29.4?±?39.4 vs. 7.3?±?4.6, p?=?0.005), LDL-C (120?±?25.7 vs. 87?±?39.3, p?=?0.045) and lower HDL-C (39.6?±?11 vs. 45.9?±?11.8, p?=?0.031) levels than the control subjects. There was a significantly positive correlation between MMP-2 level with neopterin, total cholesterol and TG levels and negative correlation with HDL-C level in SLE patients with CVD. MMP-2 G1575A allele may be a risk factor for SLE. The carriers of this allele have high levels of MMP-2, neopterin, total cholesterol and TG and lower levels of HDL, thus, they are more likely to develop heart disease.