Interactions between immune response to fungal infection and microRNAs: The pioneer tuners

Due to their physiological and biological characteristics, numerous fungi are potentially emerging pathogens. Active dynamicity of fungal pathogens causes life-threatening infections annually impose high costs to the health systems. Although immune responses play crucial roles in controlling the fate of fungal infections, immunocompromised patients are at high risk with high mortality. Tuning the immune response against fungal infections might be an effective strategy for controlling and reducing the pathological damages. MicroRNAs (miRNAs) are known as the master regulators of immune response. These single-stranded tuners (18-23 bp non-coding RNAs) are endogenously expressed by all metazoan eukaryotes and have emerged as the master gene expression controllers of at least 30% human genes. In this review article, following the review of biology and physiology (biogenesis and mechanism of actions) of miRNAs and immune response against fungal infections, the interactions between them were scrutinised. In conclusion, miRNAs might be considered as one of the potential goals in immunotherapy for fungal infections. Undoubtedly, advanced studies in this field, further identifying of miRNA roles in governing the immune response, pave the way for inclusion of miRNA-related immunotherapeutic in the treatment of life-threatening fungal infections.     

The effect of cumin supplementation on metabolic profiles in patients with metabolic syndrome: A randomized,triple blind,placebo‐controlled clinical trial

Metabolic syndrome (MetS) is a cluster of interconnected serious disorders, which is a major health problem whose prevalence is increasing. Oxidative stress and inflammation contribute to the disease pathogenesis and its complications. The present study aimed to investigate the effect of Cuminum cyminum L. (which has antioxidant and anti‐inflammatory properties) essential oil (CuEO) supplementation on inflammatory and antioxidant status in patients with MetS. In this clinical trial, 56 patients with MetS aged 18–60 years received either 75‐mg CuEO or placebo soft gel, thrice daily, for 8 weeks. Data on anthropometric parameters, food consumption, tumor necrosis factor alpha, high‐sensitivity C‐reactive protein, superoxide dismutase (SOD), glutathione peroxidase, catalase, total antioxidant capacity (TAC), and malondialdehyde (MDA) were assessed at the beginning and at the end of the study. Compared with the placebo group, CuEO increased SOD (149.17; 95% CI, [67.93, 230.42]), TAC (0.24; 95% CI, [0.09, 0.38]) and decreased MDA (?0.36; 95% CI, [?0.66, 0.06]), (p < 0.01). In within‐group analysis, CuEO led to 13.3% decrease in MDA and 6.7% increase in TAC levels (p < 0.04). The results indicated that CuEO supplementation can improve some antioxidative indices, as SOD and TAC, while decreasing MDA in patients with MetS.     

Intravenous rt-PA is not Associated with Increased Risk of Hemorrhage in Patients with Intracranial Aneurysms

Background and Purpose

The presence of an intracranial aneurysm is listed as an exclusion criterion for the administration of recombinant tissue-plasminogen activator (rt-PA). This study was designed to test the hypothesis that the administration of rt-PA is safe in patients who have an unruptured intracranial aneurysm.

Methods

We performed a retrospective analysis of all acute ischemic stroke patients treated with rt-PA at our tertiary care academic medical center from June 2006 to June 2010 who also received intracranial vessel imaging. Baseline clinical characteristics were prospectively determined. Identification of hemorrhage and the presence of aneurysm were obtained from radiology report, and neuro-imaging findings were confirmed by study investigators. Symptomatic intracerebral hemorrhage (sICH) was defined according to National Institutes of Neurological Disorders and Stroke criteria.

Results

Five percent of patients (8/172) had at least one intracranial aneurysm on vessel imaging. A total of seven patients (4?%) had sICH. There was no significant difference in intracranial aneurysms between patients with or without sICH [1/7 (14?%) vs. 7/165 (4.2?%), p?=?0.29]. In one patient with sICH and an intracranial aneurysm, the location of hemorrhage was distant from the aneurysm. The only predictors found for sICH in our cohort were atrial fibrillation (p?=?0.03) and infarct size (p?=?0.0004).

Conclusions

Incidental intracranial aneurysms are common in patients who were present with acute ischemic stroke and not associated with sICH in our population. The concern that these patients are at increased risk of hemorrhage after thrombolysis may not be warranted.     

Isolated hyoid bone fracture: a case report and review of the literature

Isolated hyoid bone fractures secondary to trauma other than strangulation are rare and have few, if any, complications. We report a case of an isolated hyoid bone fracture that resulted in sudden and severe upper airway compromise. Diagnosis of these fractures is difficult and usually can be made only with a strong degree of suspicion. Patients who suffer neck injuries in whom a hyoid fracture is diagnosed or strongly suspected should be observed for 48 to 72 hours, considered for endoscopy, and treated as warranted.     

Evaluating a semi‐nested PCR to support histopathology reports of fungal rhinosinusitis in formalin‐fixed paraffin‐embedded tissue samples

BackgroundFungal rhinosinusitis (FRS) encompasses a various spectrum of diseases. Histopathology is the “reference method” for diagnosing FRS, but it cannot determine the genus and species. Moreover, in more than 50% of the histopathologically proven cases, the culture elicited no reliable results. This study was an attempt to evaluate the diagnostic efficiency of semi‐nested polymerase chain reaction (PCR) from formalin‐fixed paraffin‐embedded (FFPE) functional endoscopic sinus surgery (FESS) in FRS patients.MethodsOne hundred ten specimens were subjected to DNA extraction and histopathology examination. The amplification of the β‐globin gene by conventional PCR was used to confirm the quality of extracted DNA. The semi‐nested PCR was performed using ITS1, ITS2, and ITS4 primers during two steps. Sequencing the internal transcribed spacer region (ITS1‐5.8S‐ITS2) to identify causative agents was performed on PCR products.ResultsSixty‐four out of 110 samples were positive by histopathology evidence, of which 56 samples (87.5%) were positive by PCR. Out of 46 negative samples by histopathological methods, five samples (10.9%) yielded positive results by PCR. Sensitivity, specificity, positive predictive value, and negative predictive value of the semi‐nested PCR method were reported 87.5%, 89.2%, 92.7%, and 85.2%, respectively. The kappa factor between PCR and histopathological methods was 0.76, indicating substantial agreements between these two tests.ConclusionDue to the acceptable sensitivity and specificity of the present method, it might be used to diagnose fungal sinusitis infections along with microscopic techniques. This method is recommended to confirm the diagnose of suspected fungal sinusitis with negative histopathology results.     

Effects of cumin (Cuminum cyminum L.) essential oil supplementation on metabolic syndrome components: A randomized,triple‐blind,placebo‐controlled clinical trial

Prevalence of metabolic syndrome (MetS), as a major health problem, is increasing. Very limited data exist on the effect of Cuminum cyminum L. essential oil (CuEO) on MetS components. Accordingly, this study aimed to examine the effect of CuEO supplementation on anthropometric indices, glycemic control, blood pressure, lipid profile, and insulin resistance in patients with MetS. In a randomized, triple‐blind, placebo‐controlled clinical trial, 56 patients with MetS aged 18–60 years received either 75 mg CuEO or placebo soft gel thrice daily for 8 weeks. Anthropometric indices and biochemical measurements were assessed at baseline and end of the study. At the end of study, except for diastolic blood pressure (DBP), the other assessed variables were not significantly different between two groups. In intra group analysis, placebo and CuEO groups both had nonsignificant decrements in DBP (mean difference [MD] with 95% CI: ?3.31 [?7.11, 0.47] and ?1.77 [?5.95, 2.40] mmHg, respectively). However, DBP was significantly lower in CuEO compared with the placebo group at the end of study (81.41 ± 5.88 vs. 84.09 ± 5.54 mmHg, MD with 95% CI: ?3.98 [?7.60, ?0.35] mmHg, p < .05). The results indicated that CuEO does not have any effect on MetS components, except for DBP in patients with MetS.