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OBJECTIVE Despite its generally favorable prognosis at primary diagnosis, recurrence of endometrial cancer remains an important clinical challenge. The aim of this study was to analyze the value of molecular classification in recurrent endometrial cancer. METHODS This study included patients with recurrent endometrial cancer who underwent primary surgical treatment between 2004 and 2015 at the Karolinska University Hospital, Sweden and the Bern University Hospital, Switzerland (KImBer cohort) with molecular classification of the primary tumor. RESULTS Out of 594 molecularly classified endometrial cancer patients, 101 patients experienced recurrence, consisting of 2 POLEmut, 33 MMRd, 30 p53abn, and 36 NSMP tumors. Mean age at recurrence was 71 years and mean follow-up was 54 months. Overall, median time to first recurrence was 16 months (95% CI 12-20); with the shortest median time in MMRd patients, with 13 months (95% CI 5-21). The pattern of recurrence was distinct among molecular subgroups: MMRd tumors experienced more locoregional, while p53abn cases showed more abdominal recurrences (P = .042). Median survival after recurrence was best for MMRd cases (43 months, 95% CI 11-76), compared to 39 months (95% CI 21-57) and 10 months (95% CI 7-13) for the NSMP and p53abn cases respectively (log-rank, P = .001). CONCLUSION Molecular classification is a significant indicator of survival after recurrence in endometrial cancer patients, and patterns of recurrence differ by molecular subgroups. While MMRd endometrial cancer show more locoregional recurrence and the best survival rates after recurrence, p53abn patients experience abdominal recurrence more often and had the worst prognosis of all recurrent patients.

Background: Pseudomonas aeruginosa is one of the major nosocomial pathogens with a vast antibiotic resistance and great ability in adaptation with environment. The purpose of this study was to evaluate the antibiotic resistance and bacterial detection using Exotoxin A (ETA) and algD genes in patients with burns wound infection. Methods: In this study, 188 samples were evaluated with standard bacteriological methods. After antibiotic resistance evaluation with disc diffusion method (Kirby-Bauer), specific primers for detection of algD and ETA genes among bacterial isolate were used. All data were analyzed using SPSS software. Findings: From 188 taken samples, 91 isolates were Pseudomonas aeruginosa. The antibiotic resistance rate for cefotaxime, cefepime, amikacin, ceftazidime, gentamicin, piperacillin, ciprofloxacin and imipenem were 80 (87.9%), 77 (84.6%), 69 (75.8%), 67 (73.6%), 66 (72.6%), 63 (69.2%), 62 (68.2%) and 53 (58.2%), respectively. The prevalence of algD and ETA genes were 88 (96.7%) and 79 (87.0%), respectively. Conclusion: The high prevalence of algD and ETA genes among burns wound infections demonstrates the increase in pathogenesis of Pseudomonas aeruginosa and problems with burn wound infection treatment. Therefore, accurate and rapid diagnosis of resistant Pseudomonas aeruginosa can be useful in taking proper strategy for prevention and treatment of such infections.

Background: Acinetobacter baumanniii is a highly antibiotic-resistant nosocomial opportunistic pathogen possess. This study aimed to assess the antibiotic-resistance pattern and detect the molecular frequency of aphA6 and aadB genes in Acinetobacter baumannii isolated from patients in intensive care unit (ICU). Methods: In this cross-sectional study, 58 Acinetobacter baumannii isolates collected from ICU patients in Imam Reza hospital, Kermanshah, Iran, were confirmed using standard bacteriological tests. Disc diffusion method was deployed for screening resistant isolates. The prevalence of aphA6 and aadB genes was assessed using polymerase chain reaction (PCR) method with specific primers. Findings: The highest antibiotic resistance rates were seen in ticarcilin (87.9%) and ceftazidime (86.2%) and the lowest was of polymyxin B (12.1%). Of 58 Acinetobacter isolates, 36 (62.1%) and 9 (15.5%) harbored aphA6 and aadB genes, respectively. In addition, 5 isolates (8.6%) harbored both genes and 18 isolates (31.3%) were negative for any of those genes. Conclusion: 80% of Acinetobacter isolates showed resistance to aminoglycoside antibiotics. Considering the high rates of antibiotic resistance to this category and other investigated antibiotics in this study, it seems necessary to precise on the use of antibiotics such as polymyxin B to treat the infections caused by this pathogen.

Objective Jaundice is a common problem in neonatal period. Phototherapy is the most common treatment for neonatal jaundice. The purpose of this study was to determine the effect of adding white plastic cover around the phototherapy unit on hyperbilirubinemia in full term neonates with jaundice. Methods In this randomized controlled trial, over 12 months (October 2009 – September 2010), 182 term neonates with uncomplicated jaundice, admitted to neonatal unit of Imam Reza Hospital (AS) in Kermanshah province of Iran, were selected. They were randomized in two groups. Control group received conventional phototherapy without cover around the apparatus and covered group received conventional phototherapy with plastic cover around the unit. After enrolment, total serum bilirubin was measured every 12 hours. Phototherapy was continued until the total serum bilirubin decreased to or less than 12.5 mg/dl. Findings There were no significant differences between the two groups for gestational age, birth weight, postnatal age, weight (at admission), serum level of hemoglobin, hematocrit and reticulocyte count. Total serum bilirubin in covered group, during the first 48 hours of treatment, declined significantly than in control group (P. value=0.003). The cover around the phototherapy unit not only did not increase the side effects of phototherapy, but also had a positive impact in reducing duration of jaundice (P. value