The Journal of Current Biomedical Reports (J Curr Biomed Rep) is an independent, peer-reviewed, open-access journal dedicated to the advancement of biomedical sciences, with a primary focus on local and regional health issues in Iran. The journal publishes high-quality research that addresses key challenges in the fields of Microbiology, Immunology, Biochemistry, and related biomedical disciplines, with a strong emphasis on translational, clinical, and public health applications. In addition to its regional orientation, the journal also serves as a scientific platform for research from neighboring countries and for international biomedical studies that align with its aims and scope. J Curr Biomed Rep welcomes original research articles, review papers, short communications, case reports, and letters to the editor that address current trends and challenges in biomedical science. The journal aims to promote interdisciplinary collaboration among clinicians, researchers, and public health professionals by providing a platform for the timely dissemination of scientific findings that influence patient care and healthcare systems. The journal particularly values studies that offer insights into region-specific health issues, disease patterns, and biomedical priorities, especially those relevant to Iran and neighboring regions. Read more
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Recent developments in vaccine research:Novel platforms and applications in global health
Copyright (c) 2025 Sina Salem Ahim, Mahnaz Mohammadnezhad, Nilufar Bavafa https://creativecommons.org/licenses/by-nc/4.0
Impact of genetic variants on outcomes in ICU patients with acute respiratory failure syndromes
Acute respiratory failure (ARF) and acute respiratory distress syndrome (ARDS) represent major causes of morbidity and mortality in the intensive care unit (ICU). Although clinical triggers such as pneumonia, sepsis, trauma, and viral infections are well characterized, substantial inter-individual variability in disease susceptibility, severity, and treatment response suggests an important contribution of genetic factors. Emerging evidence from genome-wide association studies, polygenic analyses, and sequencing of rare variants highlights key pathways including endothelial barrier regulation, innate immunity, and inflammatory signaling that shape host responses during critical illness. Pharmacogenomic studies further indicate that genetic variation influences responses to sedatives, corticosteroids, and other ICU therapies, although clinical translation remains limited. Environmental exposures and critical care interventions interact with inherited variation, emphasizing the multidimensional nature of ARF. This review synthesizes current knowledge on genetic determinants of ARF and ARDS, examines their relationship with clinical outcomes in the ICU, and outlines how gene-environment interactions and pharmacogenomics contribute to treatment heterogeneity. Despite promising discoveries, major gaps persist, including limited ancestry diversity, modest effect sizes, and scarce genotype-informed interventional trials. A deeper integration of genomics with multi-omics profiling and clinical phenotyping is essential to advance precision medicine approaches for critically ill patients.
Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
Integron profiles and sulfonamide resistance genes in Klebsiella pneumoniae isolated from diabetic patients with urinary tract infection
Klebsiella pneumoniae is an opportunistic pathogen and an important cause of pneumonia, bacteremia and urinary tract infection (UTI). K. pneumoniae infection is historically associated with diabetes. Therefore, the aim of the present study was to determine the Integron types and sulfonamide resistance genes in K. pneumoniae isolated from diabetic patients with urinary tract infection. In this descriptive-cross-sectional study, 90 K. pneumoniae isolates were collected from urine samples of diabetic patients. Antibiotic susceptibility testing was performed using disk diffusion methods. Detection of the sulfonamide resistance determinants and integron types were carried out through PCR. In this study, 90 K. pneumoniae isolates were obtained from diabetic patients with UTI, with a mean age of 69.8 ± 9.2 years; 58.9% were female. Antibiotic resistance was highest to gentamicin (70%) and ceftriaxone (65.5%), and lowest to imipenem (32.2%), with significant resistance also observed to trimethoprim-sulfamethoxazole (50%). Among the isolates, sul1 (91.8%) and intI (67%) were the most prevalent resistance genes followed by dfrA1 (63%) and sul2 (52%). The dfrA5 gene was not detected in any of the isolates. The predominance of sul1 and class I integrons among K. pneumoniae isolates from diabetic patients with UTI underscores their key role in the spread of multidrug resistance. These findings emphasize the importance of targeted antimicrobial stewardship, infection control, and monitoring strategies to prevent treatment failure in this high-risk population.
Predicting critical care outcomes in acute respiratory infections: The interplay between host comorbidities and immune status
Acute respiratory infections (ARIs) are a major cause of global critical illness and remain a leading reason for intensive care unit (ICU) admission and mortality. While pathogen-related factors and treatment timing have long dominated prognostic research, recent evidence highlights the decisive influence of host characteristics, particularly comorbidities and immune competence, on clinical outcomes. Chronic diseases such as diabetes, cardiovascular disorders, chronic kidney or liver disease, and chronic obstructive pulmonary disease substantially modify the course of ARIs by amplifying systemic inflammation, altering immune regulation, and impairing pulmonary and multi-organ recovery. Similarly, primary and secondary immunosuppression arising from malignancy, transplantation, or therapeutic interventions further increase the risk of severe infection, ventilator dependency, and mortality. Despite these associations, current prognostic models in respiratory critical care largely depend on physiologic or pathogen-specific variables, overlooking the complex host interplay that determines disease severity and treatment response. This narrative review synthesizes contemporary evidence on how comorbidities and immune alterations shape outcomes in critically ill patients with ARIs, with a focus on mortality, duration of mechanical ventilation, and ICU length of stay. It addresses key research questions regarding the relative contribution of host versus pathogen factors, the prognostic value of immune-inflammatory biomarkers, and the potential integration of host data into predictive models. Understanding this interplay is essential for advancing precision critical care, guiding individualized management, and informing the development of ethical, host-inclusive frameworks for ICU triage and resource allocation in increasingly multimorbid populations.
Bacterial pathogens and antibiotic resistance in bloodstream infections: A three-year retrospective analysis from a tertiary hospital in Northern Iran
Bloodstream infections (BSIs) are a major contributor to morbidity and mortality among hospitalized patients, particularly when antimicrobial resistance is rapidly increasing. The increasing prevalence of multidrug-resistant bacteria poses significant challenges to empirical treatment and infection-control efforts. This study aimed to determine the prevalence, bacterial etiology, and antimicrobial susceptibility patterns of BSIs among inpatients at a tertiary hospital in northern Iran over a three-year period. A retrospective observational analysis was conducted at a tertiary university hospital from March 2021 to March 2024. All hospitalized patients with culture-confirmed BSIs and documented antimicrobial susceptibility testing results were included. Bacterial identification followed standard microbiological procedures. A total of 284 cases of BSI were recorded, and based on the number of hospital admissions, the rates of nosocomial infection and BSI were approximately 4% and 1%, respectively. The mean patient age was 59.7 years, and 32.4% were admitted to ICUs. Gram-negative bacteria predominated, with Klebsiella spp. (18.3%), Escherichia coli (18.0%), and Acinetobacter spp. (12.7%) as the most frequent pathogens. High antimicrobial resistance rates were observed among Gram-negative isolates, particularly non-fermenters. Carbapenems and aminoglycosides remained the most active agents against Enterobacterales. Among Gram-positive bacteria, approximately half of staphylococcal isolates were methicillin-susceptible, and enterococci showed full susceptibility to vancomycin. BSIs continue to impose a significant clinical burden in northern Iran, dominated by Gram-negative pathogens and marked antimicrobial resistance. The findings highlight the need for ongoing local surveillance, updated empirical treatment guidelines, and reinforced antimicrobial-stewardship and infection-control programs to reduce morbidity, mortality, and the spread of resistant organisms.
Lung cancer and the microbiome: Key bacterial players in carcinogenesis and therapy
Lung cancer remains the leading cause of cancer-related mortality worldwide, with non–small cell lung cancer (NSCLC) constituting the majority of cases. Despite therapeutic advances in chemotherapy, targeted therapy, and immune checkpoint inhibitors (ICIs), treatment outcomes remain heterogeneous. Increasing evidence indicates that the human microbiome including the respiratory, gut, and intratumoral compartments plays a crucial role in lung carcinogenesis and therapeutic response. This narrative review synthesizes recent findings on the microbiome’s contribution to lung cancer biology and therapy. The healthy lung microbiota is characterized by low biomass yet consistent phyla composition, primarily Bacteroidetes and Firmicutes, while dysbiosis in lung cancer often features enrichment of Streptococcus, Veillonella, Prevotella, Haemophilus, and Fusobacterium. These taxa may drive carcinogenesis through immune modulation, chronic inflammation, metabolic signaling, and genotoxic or epigenetic alterations. Beyond the lung, gut microbial diversity and metabolites such as short-chain fatty acids (SCFAs) influence systemic immunity and modulate response to chemotherapy, targeted agents, and ICIs. Antibiotic-induced dysbiosis has been linked to reduced immunotherapy efficacy and shorter progression-free survival in NSCLC cohorts. Emerging microbiome-modulation strategies including probiotics, prebiotics, dietary interventions, fecal microbiota transplantation (FMT), and engineered bacterial therapeutics show promise as adjuncts to precision oncology. However, safety, reproducibility, and mechanistic causality remain major challenges. Collectively, evidence supports the microbiome as a dynamic regulator of lung cancer progression and therapy responsiveness. Future research should prioritize longitudinal, multi-omics investigations and controlled clinical trials to identify predictive microbial biomarkers and develop standardized, personalized microbiome-based interventions for lung cancer management.
From empirical to precision therapy in ICUs: Rethinking antibiotic use after COVID-19
Prevalence of hospital-acquired infections in burn patients: A six-year experience from northern Iran
Burn injuries represent a major public health problem, particularly in low- and middle-income countries, where hospital-acquired infections (HAIs) are one of the leading cause of morbidity and mortality. Burn patients are especially vulnerable due to loss of skin barrier, immune suppression, prolonged hospitalization, and invasive procedures. Therefore, this study aimed to determine the six years prevalence of HAIs in burn patients admitted to a subspecialty center for burn accidents. A retrospective cross-sectional study was conducted at Velayat Hospital, Rasht, northern Iran, including all burn patients admitted between March 2018 and March 2023 with hospital stays longer than 48 hours. Demographic, clinical, microbiological, and outcome data were extracted from hospital records. A total of 1,098 HAIs were documented, corresponding to a prevalence of 3.7%. The mean age of infected patients was 39.4 ± 20.7 years, and 74.1% were male. Skin and soft tissue infections were most frequent (89%), followed by ventilator-associated pneumonia (VAP) (5%), bloodstream infections (4.1%), and urinary tract infections (1.5%). Pseudomonas spp. (33.1%) and Klebsiella spp. (14.1%) were the leading pathogens. Mortality occurred in 29% of infected patients, with the highest rate among VAP cases (80%). Higher TBSA burns (>30%) and older age were significantly associated with mortality. HAIs remain a serious complication among burn patients, with Pseudomonas spp. as the predominant pathogen and VAP as the leading risk factor of death. Targeted infection-control strategies, improved microbiological diagnostics, and focused interventions for high-TBSA patients are critical to improving outcomes in burn centers.
Post-COVID-19 invasive fungal infections in pulmonary ICU patients: Diagnosis, management, and clinical challenge
Invasive fungal infections (IFIs) are among the most significant and challenging complications in critically ill patients, particularly those with underlying pulmonary diseases. Common causative organisms include Aspergillus, Candida, and Mucorales, which are associated with high morbidity and mortality due to delayed diagnosis, nonspecific clinical presentation, and host immune suppression. This narrative review provides a comprehensive overview of the epidemiology, pathophysiology, diagnostic methods, therapeutic options, and clinical challenges of pulmonary IFIs in intensive care unit (ICU) patients. Risk factors, advances and limitations in imaging, laboratory diagnostics including cultures, biomarkers, and molecular techniques, as well as antifungal treatment strategies are discussed. The review also addresses emerging issues such as antifungal resistance, adjunctive therapies, and the critical role of early recognition in improving clinical outcomes. The aim is to guide ICU clinicians in the effective management of critically ill pulmonary patients with invasive fungal infections while highlighting future research directions.
The CRISPR‒Cas9 system for genome editing of the ASS1 gene in human cells to predict its effect on HSV-1 replication
Herpes simplex virus type 1 (HSV-1) is a highly contagious pathogen that establishes lifelong latent infections. The replication of HSV-1 is potentially influenced by the arginine succinate synthase (ASS1) gene, a key regulator of cellular metabolism. This study utilized the CRISPR–Cas9 genome editing platform to specifically target and disrupt the ASS1 gene to examine its effect on viral propagation. A guide RNA (gRNA) was designed to complement a sequence within the ASS1 gene. A donor plasmid and the pCas-guide plasmid were cloned and cotransfected into the human embryonic kidney (HEK) cells with sheared adenovirus (Ad)5 DNA (HEK293-AD) cells. Potential ASS1-knockout clones were identified and validated via polymerase chain reaction (PCR) and DNA sequencing analysis. The impact on HSV-1 replication was quantified via a plaque assay to determine the viral titer. Sequencing data from ASS1-gRNA/Cas9-treated cells did not confirm successful gene knockout, as the intended ASS1 disruption was not achieved. The viral titer did not significantly differ between the HSV-1 infection group (MOI=0.01) and the control group. These findings indicate that the single gRNA designed for this study lacked sufficient specificity to elicit a CRISPR-Cas9-mediated gene knockout. Therefore, employing a set of more specific gRNAs is recommended to increase targeting efficiency. Further investigations are needed to elucidate the desired genetic modification and observe its subsequent effects on HSV-1.
Impact of Helicobacter pylori infection on diabetes: A cross-sectional investigation in Northern Iran
Globally, Helicobacter pylori represents one of the leading chronic infections, and is suspected to contribute to extra-digestive diseases, notably diabetes mellitus (DM). Despite growing interest, data from Middle Eastern populations are limited. This study was conducted to determine the occurrence of diabetes and explore its relationship with H. pylori infection. This analytical cross-sectional study included 383 patients with histologically confirmed H. pylori infection admitted to a tertiary care center in the North of Iran, between March 2021 and March 2023. Demographic records, diabetes status, fasting blood glucose (FBS), and gastritis severity were extracted from medical archives. Diabetes was defined using international diagnostic criteria. Among the 383 patients, 90 (23.5%) had diabetes. Diabetic patients were significantly older than non-diabetics (63.5 ± 10.8 vs. 56.3 ± 17.8 years, p<0.001), and diabetes prevalence increased with age, reaching 36.7% in patients ≥70 years. FBS was markedly higher in diabetic patients compared with non-diabetics (173.8 ± 48.5 vs. 100.6 ± 14.4 mg/dL, p<0.001). No significant association was observed between diabetes and gender (p=0.059) or gastritis severity (p=0.692). Duration of diabetes did not differ significantly across gastritis grades (p=0.352). Nearly one-quarter of patients with H. pylori infection in Northern Iran had diabetes, with older age and higher FBS significantly associated with its presence. Our analysis did not reveal a significant link between diabetes and the histological severity of gastritis. These results underscore the necessity for prospective research to elucidate the causal mechanisms linking H. pylori infection and diabetes.
Molecular mechanism linking sleep disturbances to neurodegenaration
Sleep disturbances are increasingly recognized as both early indicators and potential contributors to the progression of neurodegenerative diseases. Disrupted sleep compromises glymphatic clearance and synaptic homeostasis, promoting the accumulation of neurotoxic proteins such as amyloid-β, tau, and α-synuclein. Concurrently, irregular sleep patterns and circadian rhythm disturbances activate neuroinflammatory pathways, including microglial activation, NF-κB signaling, and the NLR family pyrin domain containing 3 (NLRP3) inflammasome, thereby accelerating neuronal damage. Additional mechanisms, such as mitochondrial dysfunction, oxidative stress, and imbalances in neurotransmitter systems including orexin and melatonin, further reinforce the bidirectional relationship between sleep impairment and neurodegeneration. Despite these insights, critical gaps remain, particularly the absence of reliable biomarkers for simultaneously assessing sleep quality, neuroinflammation, and disease progression, as well as limited research on disorders beyond Alzheimer’s and Parkinson’s disease. Therapeutic strategies show promise, ranging from pharmacological interventions targeting inflammatory pathways to non-pharmacological approaches such as chronotherapy, light therapy, and cognitive behavioral therapy for insomnia. Emerging modalities, including RNA-based therapies targeting pathogenic proteins and artificial intelligence (AI) for early detection and personalized treatment of sleep abnormalities, offer novel opportunities for intervention. This narrative review explores the molecular mechanisms underlying sleep disturbances in neurodegenerative diseases, identifies critical gaps in current research, and discusses emerging therapeutic strategies aimed at mitigating sleep-related neurodegeneration.
COVID-19 in patients with preexisting liver disease: Clinical features and outcomes from northern Iran
People living with chronic liver disease (CLD) may experience more severe consequences when infected with coronavirus disease 2019 (COVID-19). However, information from Middle Eastern populations is still limited. The present research examined the presentation and outcomes of COVID-19 among patients with underlying liver disorders in Northern Iran. To achieve this, a retrospective cross-sectional review was carried out in a major referral hospital between March 2020 and March 2023. Adult patients with confirmed COVID-19 and documented preexisting liver disease were included. Demographic, clinical, and outcome data were extracted and analyzed. Among 83 identified patients, common symptoms were myalgia (59%), cough (56.6%), and respiratory distress (49.4%). Hypoxemia (25.3%) was significantly associated with mortality (47.4% vs. 18.8%, P = 0.017). Altered consciousness also predicted poor outcomes (31.6% vs. 9.4%, P = 0.016). COVID-19 patients with preexisting liver disease had increased risk of adverse outcomes, with hypoxemia and altered mental status serving as key mortality predictors. Early recognition and tailored management are essential for this vulnerable group.
Epigenetic markers as predictors of neurodegeneration in long COVID survivors
Effect of anticoagulant therapy on the severity symptoms of hospitalized patients with COVID-19
Coronavirus disease 2019 (COVID-19) has been associated with a hypercoagulable state, contributing to disease severity and increased mortality. Thrombotic complications, including venous thromboembolism (VTE) and microvascular thrombosis, have been frequently reported in hospitalized patients. So, the study aimed to evaluate the effect of anticoagulant therapy on the severity of symptoms and clinical outcomes in hospitalized COVID-19 patients. An analytical retrospective, single-center study was conducted on hospitalized adult patients diagnosed with COVID-19. Demographic, clinical, and laboratory parameters, including age, hospitalization duration, ICU stay, ventilation, and biochemical markers, were compared across severity groups in patients <18 years. All patients received anticoagulation therapy according to hospital guidelines for at least one week, with exclusions for prior anticoagulant use, thrombosis, or incomplete records. Patients receiving anticoagulant therapy, particularly low molecular weight heparin (LMWH), showed a significant reduction in disease severity, ICU admission rates, and in-hospital mortality compared to those not receiving anticoagulation (P <0.05). The incidence of thrombotic events was also lower among anticoagulated patients. However, bleeding complications were observed in a small proportion of patients, emphasizing the need for individualized risk assessment. Anticoagulant therapy, especially LMWH, may reduce the severity and improve clinical outcomes in hospitalized COVID-19 patients. Despite its benefits, anticoagulation should be carefully administered based on thrombotic and bleeding risks. Further randomized controlled trials are needed to confirm these findings and to establish evidence-based protocols for anticoagulant use in COVID-19 treatment.
Vitamin D status and ventilator-associated pneumonia in critically ill patients: A case-control study in northern Iran
Ventilator-associated pneumonia (VAP) is a major contributor to illness and death among patients in intensive care units (ICUs). While vitamin D deficiency is known to compromise immune defenses and elevate the risk of infections, its specific association with VAP has yet to be clearly established. So, we aimed to evaluate vitamin D in patients with VAP admitted to the ICU. In this case-control study, 141 ICU patients from two hospitals in northern Iran were enrolled. Serum 25-hydroxyvitamin D levels were measured within 48 hours of ICU admission. VAP diagnosis was based on clinical and microbiological criteria ≥48 hours after mechanical ventilation. Demographic data, laboratory parameters, and mechanical ventilation duration were recorded. Vitamin D insufficiency was present in 73.7% of patients. The mean serum vitamin D level did not differ significantly between VAP and non-VAP groups; however, sufficiency was nearly twice as common in the non-VAP group. Multivariate analysis identified elevated white blood cell count (OR = 2 per 1000 cells/µL, p < 0.001) and reduced platelet count (OR = 0.98, p = 0.005) as independent predictors of VAP, while vitamin D status was not statistically significant. Vitamin D deficiency is highly predominant in ICU patients but was not an independent predictor of VAP in this study. Nevertheless, the observed trend toward higher vitamin D sufficiency in non-VAP patients, along with previous evidence, suggests potential benefits of supplementation. Larger randomized controlled trials are warranted to clarify its preventive role in VAP.
Targeted mechanisms and novel therapeutic strategies against extended-spectrum beta-lactamases: From precise detection to intelligent management of bacterial resistance
Extended-spectrum beta-lactamases (ESBLs) are enzymes that resist beta-lactam antibiotics, including penicillins, cephalosporins, and carbapenems, and are produced by a variety of bacteria, including Escherichia coli and Klebsiella pneumoniae. Since ESBLs are often plasmid-borne, antibiotic resistance can spread across bacteria due to their ease of transfer. The intricate structure of ESBLs changes based on the type of bacterium that produces them. However, they all share a beta-lactamase core structure. ESBLs act by hydrolyzing the beta-lactam ring of antibiotics thereby rendering them ineffective. Detection of ESBL-producing bacteria is very important for effective treatment of infections. These enzymes can be identified through various diagnostic methods, such as phenotypic tests and molecular assays. The most common diagnostic method is an antimicrobial susceptibility test, which involves testing bacterial sensitivity to different antibiotics. Furthermore, the use of molecular testing techniques like polymerase chain reaction is growing in the identification of ESBLs. This paper provides a summary of ESBLs, including their structure, function, and diagnostic methods. Thus, it is critical to comprehend ESBLs in order to create therapies that effectively address illnesses brought on by bacteria that produce ESBL.
Cinnamomum verum (Cinnamon): A promising natural alternative for urinary tract infection treatment
Copyright (c) 2024 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
Evaluation of prevalence and phylogenetic analysis of Wolbachia pipientis isolated from Dirofilaria immitis of canids in northern Iran
Dirofilaria immitis and Dirofilaria repens, two mosquito-borne filarial nematodes, are the primary causes of subcutaneous and cardiopulmonary dirofilariasis in humans and canines. Wolbachia pipientis infection is widespread among arthropods and nematodes globally. One safe, cost-effective, and efficient way to avoid dirofilariasis infections is to eradicate Wolbachia. So, herein we determined the prevalence and phylogenetic analysis of W. pipientis strains isolated from D. immitis of canids in northern Iran. A descriptive-analytical cross-sectional study from March 2019 to April 2020 in Guilan province, north of Iran, was conducted. Sampling consisted of 32 road-killed carnivores (12 Canis familiaris and 20 Canis aureus) were gathered and necropsied for this study. The 16S ribosomal RNA (rRNA) gene was the basis for the molecular analysis. D. immitis infection was discovered in 7/20 (35%) of the jackals and 9/12 (75%) of the dogs. The W. pipientis infection was present in all 16 of the infected dogs and jackals. In this study, 16S rRNA sequences had 100% similarity with previously submitted W. pipientis sequences from the USA, Russia, Myanmar, and Italy. This paper hopes to provide a new vision for further studies on the symbiotic relationship between D. immitis and Wolbachia, providing an advance in the therapeutic and diagnostic approach. There is no report of molecular identification for Wolbachia spp. isolated from D. immitis in northern Iran. So, to fill this study gap, herein we determined the prevalence and phylogenetic analysis of W. pipientis strains isolated from D. immitis of canids in northern Iran.
Sub-minimal inhibitory concentrations of fluoroquinolones in the environment: A trigger for the emergence of drug-resistant bacteria
Fluoroquinolones represent a significant class of antimicrobial agents. These compounds are effective in the treatment of various enteric infections in veterinary medicine. The primary bacterial targets of quinolones are topoisomerase IV and DNA gyrase, enzymes essential for DNA replication and repair. A major public health concern is the potential transmission of fluoroquinolone-resistant bacteria from livestock to humans. The development of antimicrobial resistance in both animals and humans is interconnected. Multiple observational studies and randomized trials have established an association between the use of antibiotics in food animals and the emergence of antimicrobial-resistant bacteria. Fluoroquinolones induce DNA damage, leading to DNA strand breaks that activate the SOS response and various DNA repair pathways. The SOS system, a key component of the DNA repair machinery, plays a critical role in cell cycle regulation. Activation of this system initiates a cascade of signals within bacteria, resulting in enhanced pathogenicity. Through these signaling pathways, bacteria have evolved diverse mechanisms such as pathogenicity islands, biofilm formation, and toxin production. The presence of residual fluoroquinolones in livestock environments and animal production systems following veterinary use is associated with increased bacterial virulence. This review focuses on the impact of fluoroquinolone exposure at sub-minimal inhibitory concentrations on bacterial virulence and pathogenicity.
A decade of wild mushroom poisoning: Clinical and laboratory insights from Northern Iran
Wild mushroom poisoning remains a significant public health concern in regions where foraging is common. Limited long-term data exist for northern Iran, despite its high-risk ecological and cultural context. The present study aims to characterize the clinical and laboratory features of patients hospitalized for mushroom poisoning over a ten-year period in northern Iran. This descriptive cross-sectional study reviewed all cases of confirmed wild mushroom poisoning admitted to the Toxicology Department of Razi Hospital, Rasht, Iran, from March 2012 to March 2022. Data on demographics, medical history, exposure characteristics, clinical manifestations, laboratory findings, and outcomes were collected from hospital records and analyzed using descriptive statistics. A total of 165 patients were included (mean age 44.57 ± 16.02 years; 50.9% male). Housewives (43.0%) and self-employed individuals (29.1%) were the most affected occupational groups. Most patients (60.6%) resided in urban areas. The mean time from ingestion to hospital presentation was 9.01 ± 10.71 hours. Vomiting (90.9%) and nausea (73.3%) were the most frequent symptoms. Laboratory tests showed variable hepatic involvement, with mean AST and ALT levels of 45.72 ± 94.95 U/L and 44.02 ± 93.30 U/L, respectively. The mean length of hospital stay was 1.93 ± 1.45 days. Four patients (2.4%) died, 97.6% recovered and were discharged. Wild mushroom poisoning in northern Iran affects a wide demographic spectrum and is characterized predominantly by early gastrointestinal symptoms. Although most patients recover, the potential for severe hepatotoxicity and mortality underscores the need for preventive education, and careful inpatient monitoring to detect delayed complications.
Non-caloric artificial sweeteners: A mini-review of current perspectives on health benefits and potential risks
Non-caloric artificial sweeteners (NAS) have gained widespread use in food, beverages, and pharmaceuticals due to their intense sweetness and minimal caloric contribution. Initially introduced as sugar substitutes for weight management and glycemic control, their safety profiles have come under renewed scrutiny. This mini-review summarizes current evidence on the health benefits and potential risks associated with NAS. Clinical trials support their short-term benefits, including modest reductions in body weight, improved glycemic indices, and dental health advantages due to their non-cariogenic properties. Additionally, certain NAS exhibit antimicrobial and antioxidant activities, although these may also disrupt beneficial gut microbiota. Notably, some epidemiological studies have paradoxically linked NAS consumption with weight gain, metabolic disturbances, and cardiovascular risk. Alterations in gut microbiota, neuroendocrine signaling, and taste perception are proposed mechanisms for these effects. Emerging data also raise concerns about carcinogenic and genotoxic potential, particularly for aspartame and acesulfame-K, although findings remain inconsistent across studies. Regulatory agencies maintain acceptable daily intake limits based on toxicological assessments; however, individual susceptibility, cumulative exposure, and long-term outcomes warrant further investigation. Overall, NAS offer useful alternatives to sugar but should be consumed with awareness of potential systemic and microbiome-mediated risks. Ongoing research, particularly well-designed longitudinal human studies, is essential to inform future dietary recommendations and regulatory policies.
Cerebral and hemodynamic responses in elderly patients during laparoscopic cholecystectomy: A cross-sectional study
Laparoscopic cholecystectomy is among the most frequently performed abdominal surgeries in the elderly population. However, the physiological changes in hemodynamic and cerebral parameters induced by pneumoperitoneum and the head-up (reverse Trendelenburg) position present notable clinical challenges in this age group. This cross-sectional study aimed to evaluate alterations in cerebral oxygenation and hemodynamic status in elderly patients undergoing laparoscopic cholecystectomy. The study was conducted on 50 elderly patients scheduled for laparoscopic cholecystectomy at Razi Hospital, Rasht, between March 20, 2023, and March 19, 2024. Hemodynamic parameters and cerebral oxygen saturation were recorded at baseline (prior to anesthesia induction), 5 and 15 minutes after abdominal gas insufflation, immediately following gas desufflation, and 15 minutes post-desufflation. The mean patient age was 66.9 ± 7.1 years, with 58% being female. Systolic, diastolic, and mean arterial pressures significantly increased following gas insufflation (P < 0.001), whereas heart rate changes were not statistically significant (P = 0.443). End-tidal carbon dioxide (EtCO₂) levels significantly rose during pneumoperitoneum. Cerebral oxygen saturation initially increased after anesthesia induction, declined post-insufflation, and subsequently recovered in the later stages. Peripheral oxygen saturation (SpO₂) remained stable throughout the procedure. The most commonly observed side effects included hypertension (16%), nausea and vomiting (16%), and bradycardia (8%). The findings indicate that anesthesia induction, pneumoperitoneum, and the reverse Trendelenburg position influence both cardiac function and cerebral perfusion in elderly patients. Specifically, carbon dioxide insufflation into the abdominal cavity is associated with elevated hemodynamic parameters, increased EtCO₂, and transient reductions in cerebral oxygenation across both hemispheres.
Nanoemulsions as emerging antifungal carriers: Potential beyond conventional boundaries
Surveillance of nosocomial infections in kidney and liver transplant recipients in Rasht, Northern Iran
Solid organ transplant (SOT) recipients are at heightened risk of hospital-acquired infections (HAIs) due to immunosuppressive therapy and frequent exposure to invasive procedures. HAIs, particularly those caused by multidrug-resistant (MDR) organisms, remain a major source of morbidity, prolonged hospitalization, and mortality in this population. Despite the global significance of this issue, regional data on post-transplant HAIs and antimicrobial resistance in Northern Iran remain limited. This study aimed to investigate the prevalence, microbial etiology, and antibiotic resistance patterns of HAIs among kidney and liver transplant recipients at a tertiary referral hospital in Rasht, Iran. A retrospective cross-sectional study was conducted at Razi Hospital from March, 2018, to February, 2023. Clinical, microbiological, and demographic data were collected for transplant recipients diagnosed with HAIs ≥48 hours after hospital admission. Among 141 transplant recipients, 14 (9.9%) developed confirmed HAIs. urinary tract infections were the most prevalent (57.1%), followed by bloodstream infections (21.4%), ventilator-associated pneumonia (14.3%), and surgical site infections (7.1%). The most frequently isolated organism was Escherichia coli (42.9%), followed by Staphylococcus spp., Acinetobacter spp., Citrobacter spp., and Klebsiella spp. (each 14.3%). Antimicrobial susceptibility testing revealed diverse resistance patterns among the isolated organisms; however, the rates of drug resistance among Gram-negative bacteria was high. This study highlights a moderate prevalence of nosocomial infections among transplant recipients in Northern Iran, with Gram-negative MDR pathogens posing significant therapeutic challenges. These findings emphasize the need for enhanced infection control policies, continuous microbiological surveillance, and locally informed antimicrobial stewardship programs to improve outcomes in transplant populations.
Impact of hepatitis B and C virus on chronic spontaneous urticaria; potential pathogenic triggers and aggravating factors
Chronic urticaria (CU) is a common dermatological condition characterized by persistent wheals lasting more than six weeks. Chronic spontaneous urticaria (CSU), the most prevalent CU subtype, significantly impairs patients' quality of life. Although its precise pathogenesis remains unclear, current evidence implicates multiple factors including immune dysregulation, stress, certain medications, and viral infections in its development and exacerbation. Among infectious triggers, hepatitis B (HBV) and C (HCV) viruses have emerged as potential CSU inducers. These viruses may trigger urticarial symptoms through various mechanisms, particularly immune system activation and cutaneous inflammatory responses. While the exact pathogenic pathways require further elucidation, clinical evidence suggests antiviral therapy may occasionally improve urticarial symptoms. Standard management of virus-associated CSU involves second-generation antihistamines as first-line treatment. For refractory cases, targeted therapies like omalizumab may be considered. Notably, successful HCV eradication has in some cases led to significant CSU improvement, an effect less frequently observed with HBV treatment. This study investigates the association between hepatitis infections and CSU, focusing particularly on elucidating how HBV and HCV could contribute to CSU pathogenesis.
Concurrent EGFR and KRAS mutations in non-small cell lung cancer: Challenging the paradigm of linear targeted therapy
Antimicrobial peptide-infused hydrogels: Bridging infection defense and wound regeneration
A retrospective analysis of the clinical characteristics of vaccinated COVID-19 patients admitted to a tertiary Hospital, Northern Iran
Coronavirus disease 2019 (COVID-19) vaccines have played a critical role in reducing the severity and complications of severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) infection. While various vaccine types have been administered globally, the clinical manifestations of COVID-19 among vaccinated individuals may differ based on the number of doses received. This study aimed to evaluate and compare the initial clinical characteristics of vaccinated COVID-19 patients. This retrospective descriptive-analytical study was conducted on 594 adult patients with confirmed COVID-19 who had received at least one dose of a COVID-19 vaccine. Patients were admitted to Razi Hospital in Rasht, Iran, between June 6, 2021 and March 21, 2022. Medical records were reviewed to collect demographic data, vaccination history, and clinical symptoms at admission. Patients were categorized into three groups: one dose, two doses, and three doses (booster). Clinical symptoms and oxygen saturation levels were compared across these groups. Among 594 patients, 30% had received one dose, 55.1% two doses, and 15% three doses of a COVID-19 vaccine. Fever, cough, myalgia, respiratory distress, and anosmia showed significant differences across the groups. The mean oxygen saturation was highest in the two-dose group. No significant differences were observed in comorbidities among the groups. The number of vaccine doses received was associated with differences in several clinical symptoms and oxygen saturation levels among hospitalized patients. These findings suggest a possible dose-related trend in clinical presentation among vaccinated individuals.
Association between dairy products and dyslipidemia among the PERSIAN Guilan cohort study population
Dyslipidemia is a major risk factor for cardiovascular diseases, and the role of dairy intake in modulating lipid profiles remains debated. This study aimed to investigate the association between dairy product consumption and dyslipidemia prevalence among adults in the Prospective Epidemiological Research Studies (PERSIAN) Guilan Cohort study (PGCS) population. In this cross-sectional analysis, 10,520 adults aged 35–70 years were included. Demographic and lifestyle factors were recorded, and fasting blood samples were analyzed for total cholesterol, triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). Dyslipidemia was defined as cholesterol ≥200 mg/dL, TG ≥150 mg/dL, LDL-C ≥100 mg/dL, or HDL-C ≤40 mg/dL. Dairy intake was categorized into tertiles. Dietary data were assessed using a validated and reliable Persian Food Frequency Questionnaire (FFQ). Overall, 76.4% of participants had dyslipidemia, with 40.3% having hypercholesterolemia, 43.1% hypertriglyceridemia, 29.0% high LDL-C, and 41.5% low HDL-C. Dyslipidemia prevalence showed a non-significant increasing trend with higher dairy intake (P=0.056). No significant trends were found for hypercholesterolemia, hypertriglyceridemia, or high LDL-C. A significant inverse trend was observed between dairy intake and low HDL-C in men (P=0.026); however, this association lost significance after multivariable adjustment (aOR=0.87; 95%CI: 0.73–1.02; P=0.093). This study revealed prevalent dyslipidemia across lipid profiles. Dairy intake showed a non-significant association with overall dyslipidemia and no associations with specific lipid abnormalities. A transient protective trend against low HDL-C in men disappeared post-adjustment, supporting no conclusive link between dairy consumption and dyslipidemia risk.