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Background: The effects of COVID‐19 vaccines on immunocompromised people such as hemodialysis (HD) patients are an important topic that should be addressed. This study reports an observation of the effect of the third dose of the Sinopharm vaccine (SphV3) on the level of hepatitis B surface antibody (anti‐HBs) in HD patients, and the differences between anti‐HBs titers before and after SphV3 were analytically evaluated. Methods: This single‐center observational study involved all HD patients presented to Shariati Hospital, Tehran, Iran, from February 2021 to March 2022. All patients received three doses of the Sinopharm vaccine over 8 months. The anti‐HBs level is measured every 6 months as the routine evaluation against HBV infection for all HD patients. Three months before (anti‐HBs‐B3) and 3 months after (anti‐HBs‐A3) SphV3 were the routine times to measure the anti‐HBs titer during this study. Results: Twenty‐five HD patients were enrolled. Overall, the anti‐HBs‐A3 was significantly higher than anti‐HBs‐B3 (p = 0.001). The anti‐HBs levels before and after SphV3 were not statistically remarkable in patients with diabetes and ischemic heart disease. The patients with a history of kidney transplant and those with a history of COVID‐19 had significant differences between anti‐HBs‐B3 and anti‐HBs‐A3 (p = 0.002, p = 0.003, respectively). Conclusion: Our findings revealed that inactivated COVID‐19 vaccine may be involved in the humoral immune response to hepatitis B in HD patients. It may be novel and have significant implications for the vaccination protocol for immunocompromised patients, including those undergoing HD and transplant recipients. [ABSTRACT FROM AUTHOR]

Objectives: Breast cancer is a prevalent disease that has a substantial impact on women's mortality rates. Shikonin, a naphthoquinone derived from Lithospermum erythrorhizon, has demonstrated substantial anticancer effects. This study aims to conduct a comprehensive review of the latest research findings regarding the therapeutic efficacy of shikonin in the context of breast cancer treatment, with a specific emphasis on elucidating the underlying molecular mechanisms. Methods: A comprehensive literature review was conducted on shikonin and breast cancer by searching PubMed, Scopus, Web of Science, and Google Scholar databases. Key findings: Shikonin significantly reduces tumor cell viability, proliferation, migration, invasion, and metastasis in both in vivo and in vitro across all breast cancer subtypes. Additionally, when combined with other pharmaceutical agents, it exhibits synergistic effects. Shikonin stimulates immunogenic cell death, resulting in apoptosis and necroptosis. The induction of immunogenic cell death by shikonin enhances the immunogenicity of breast cancer cells, leading to its involvement in the development of dendritic cell-based tumor vaccines against breast cancer. Conclusion: Shikonin exhibits potent anti-breast cancer properties and shows significant potential for the advancement of immunotherapeutic approaches against breast cancer, as well as enhancing the efficacy of conventional treatment strategies. [ABSTRACT FROM AUTHOR]

Background: Melatonin, mainly regulating the body's circadian rhythm, may have protective effects against type 2 diabetes mellitus (DM2)-induced depression due to its antioxidant and regulatory impact in the pathogenesis of both DM2 and depression. This study aimed to find the association of serum melatonin levels with depression in DM2 patients. Methods: A total of 50 DM2 patients were recruited in this retrospective cross-sectional study and divided into 25 patients with depression (DM2-DP) and 25 without depression symptoms (DM2-NDP). Depression was diagnosed using the Hospital Anxiety and Depression Scale (HADS) assessment. Fasting blood samples were collected and examined for the level of serum melatonin and other biomarkers. All statistical analysis was performed by SPSS software Version 22, and a p-value less than 0.05 was considered statistically significant for all tests. Results: The depression score was significantly lower in DM2-NDP than DM2-DP (p< 0.001). The mean weight was significantly lower in the DM2-DP group (P= 0.021). Total cholesterol, triglyceride, and anxiety scores were higher, and the melatonin level was lower in DM2-DP. The correlation of melatonin levels was positive with age, DBP, HbA1C, FBS, and TG. In contrast, it was negative with male gender, BMI, diabetes duration, SBP, TC, family history of DM, depression score, and anxiety score. However, no significant differences were seen. Conclusion: Lower melatonin may be associated with depression and anxiety in patients with DM2. The serum melatonin level might be a strong predictor of depression in DM2 patients. [ABSTRACT FROM AUTHOR]

Many studies support the idea that long noncoding RNAs (lncRNAs) are significantly involved in the process of cardiomyocyte (CM) regeneration following a myocardial infarction (MI). This study aimed to systematically review the emerging role of lncRNAs in cardiac regeneration by promoting CM proliferation after MI. Furthermore, the review summarized potential targets and the underlying mechanisms of lncRNAs to induce heart regeneration, suggesting utilizing lncRNAs as innovative therapeutic targets for mitigating MI injuries. We searched the PubMed, Scopus, and Web of Science databases for studies on lncRNAs that play a role in heart regeneration after MI. We used search terms that included MI, lncRNAs, CM, and proliferation. Relevant English articles published until June 11, 2023, were systematically reviewed based on inclusion and exclusion criteria. A total of 361 publications were initially identified, and after applying the inclusion and exclusion criteria, nine articles were included in this systematic review. These studies investigated the role of critical lncRNAs in cardiac regeneration after MI, including five upregulated and four downregulated lncRNAs. Acting as a competitive endogenous RNA is one of the main roles of lncRNAs in regulating genes involved in CM proliferation through binding to target microRNAs. The main molecular processes that greatly increase CM proliferation are those that turn on the Hippo/YAP1, PI3K/Akt, JAK2-STAT3, and E2F1-ECRAR-ERK1/2 signaling pathways. This systematic review highlights the significant role of lncRNAs in heart regeneration after MI and their impact on CM proliferation. The findings suggest that lncRNAs could serve as potential targets for therapeutic interventions aiming to enhance cardiac function. [ABSTRACT FROM AUTHOR]

Key Clinical Message: This report describes a rare case of developing Guillain–Barre syndrome (GBS) following receiving rabbit antithymocyte globulin (ATG) after kidney transplantation to prevent acute allograft rejection in a 34‐year‐old man. The patient presented severe pain in the right temporomandibular joint, fever, chills, myalgia, polyarthralgia, and bone pain. Twelve hours later, he developed quadriplegia, paresthesia, and a limited range of active motions in all extremities. No antecedent viral or bacterial infection was identified. The EMG/NCV evaluation displayed acute inflammatory sensory‐motor polyneuropathy. After the administration of GBS treatment, the neurologic symptoms started to improve. Over a few days, the reflexes came back completely, and the patient was able to walk. To our knowledge, this is the second case report of ATG‐related GBS after kidney transplantation. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Although anatomical and vascular abnormalities of the horseshoe kidney might be challenging, complete preoperative imaging evaluations and accurate organ‐sparing surgical planning can lead to much lower complications. Horseshoe kidney (HK) is one of the most common renal fusion anomalies. Renal carcinoids are rarely reported in HK patients. Here, we described a rare case of advanced right renal cell carcinoma (RCC) along with proximal left ureter stone in a 41‐year‐old man who presented with a complaint of turbid urine. Early blood tests revealed a blood urea nitrogen of 44 mg/dL and serum creatinine of 1.35 mg/dL. The urine analysis showed microscopic hematuria (6–8 RBCs) and few calcium oxalate crystals. The imaging evaluations revealed an HK anomaly with a solid mass on the right side and a 4 mm stone in the proximal left ureter. The findings suggested RCC which was confirmed by histopathology examination. Consequently, the patient was scheduled for an organ‐preserving open surgery of a right kidney tumor with concomitant left ureterolithotomy. The 16‐month follow‐up showed no urological complications, metastasis, or tumor proliferation. Although the anatomical and vascular abnormalities of HK might be challenging, organ‐sparing surgical treatment should be considered in feasibly resectable tumors. Complete preoperative imaging evaluations to identify the characteristics of HK, as well as accurate surgical planning, can lead to much lower complications. [ABSTRACT FROM AUTHOR]

Key clinical message: PB19 infection should be considered an uncommon cause of posttransplant anemia in renal transplant recipients, particularly those whose anemia is not associated with common etiologies. IVIG treatment and reduced immunosuppression could be beneficial. Parvovirus B19‐associated relapsing anemia is rare in kidney transplant recipients. Herein, we report a case of relapsed anemia due to parvovirus B19 infection in a 53‐year‐old woman 18 months after kidney transplantation. The patient presented with palpitations, shortness of breath, dizziness, weakness, and lethargy. Early laboratory findings showed a WBC count of 6.000/μL, RBC count of 1.89/μL, hemoglobin (Hb) 3.5 g/dL, hematocrit (Hct) 15%, platelet count 266.000/μL, MCV 89, reticulocyte count 0.8%, and serum iron 221 μg/dL. Upon further evaluation, the RT‐PCR test for BK polyomavirus and cytomegalovirus (CMV) was negative, while the parvovirus B19 RT‐PCR was positive. The patient was treated with blood transfusion and IVIG 25 g daily for 5 days. Two months after discharge, the patient presented, complaining of palpitation, shortness of breath, and dizziness, with RBC 2.7/μL, Hb 6.5 g/dL, Hct 25%, and MCV 85. Again, the CMV RT‐PCR was negative, while the parvovirus B19 RT‐PCR was positive. Tacrolimus and mycophenolic acid were stopped, and IVIG 25 g daily for 5 days was administered. Consequently, her Hb level increased to 9 g/dL, and the patient was discharged with prednisolone 5 mg daily and cyclosporine 50 mg daily instead of tacrolimus. Viral infection, particularly PB19 infection, should be considered in the differential diagnosis of posttransplantation anemia in KTRs. IVIG treatment and modification of immunosuppressive medications are suggested standard therapies for such patients. The function of transplanted kidneys should be carefully monitored during treatment. [ABSTRACT FROM AUTHOR]

A 75‐year‐old man was admitted with a diagnosis of diabetic ketoacidosis and hyperkalemia. During the treatment, he developed refractory hyperkalemia. Following our review, diagnosis of pseudohyperkalaemia secondary to thrombocytosis was made. We report this case to remind the importance of clinical suspicion of this phenomenon to prevent its serious consequences. [ABSTRACT FROM AUTHOR]

Successful conception in a female patient on hemodialysis (HD) is considered a high-risk pregnancy and associated with maternal and fetal complications. Thus, most such pregnancies lead to abortion or termination to preserve maternal health. Here, we report a successfully-delivered case of a 19thweek- diagnosed pregnancy in a 35-year-old mother with end-stage renal disease (ESRD). We present the case of a 35-year-old female with ESRD, diagnosed 10 years ago secondary to glomerulonephritis. The patient underwent the deceased--donor renal transplantation once, which unfortunately was rejected. During the initial tests for second-time kidney transplantation, a human chorionic gonadotropin-beta (beta-hCG) positive with a level of 9953 mIU/mL was reported, suggesting the pregnancy. The transvaginal ultrasonography confirmed the pregnancy at an approximate gestational age of 19 weeks. As a result, the patient underwent four and half hours of intensive HD five times a week and continued until 36 weeks of pregnancy. At 36 weeks, the patient presented to Shariati hospital, Tehran, Iran, with low- back pain. Consequently, a cesarean section (C/S) was performed, and the baby boy was born with a nine of ten Apgar score. Although successful pregnancy is possible for women with ESRD, it requires special multidisciplinary care. Intensive HD and regular fetal monitoring have improved the pregnancy outcome in this population. However, the risk of severe complications is still for the health of the mother and her offspring. [ABSTRACT FROM AUTHOR]

Background: Rare cases of acquired thrombotic thrombocytopenic purpura (aTTP) have been reported since the administration of the COVID-19 vaccination. Based on our information, the present study provides the first case report of aTTP developed after the COVID-19 vaccination in Iran. Case presentation: A 22-year-old Iranian woman presented with symptoms of ataxia, dysphasia, paresthesia, and acute numbness of her left upper limb four weeks after the AstraZeneca COVID-19 vaccination. Laboratory data suggested hemolytic anemia and thrombocytopenia. Also, schistocytes were noted on her peripheral blood smear. Acquired thrombotic thrombocytopenic purpura (aTTP) was diagnosed in accordance with clinical manifestations along with initial blood test results and was confirmed later through findings of ADAMTS-13 low level activity and the ADAMTS-13 positive inhibitor. She underwent 22 sessions of plasma exchange, receiving corticosteroid and rituximab. Finally, the treatment was successful. Conclusion: Despite the presence of rare complications such as aTTP, vaccination is one of the best ways to prevent COVID-19 disease. The present case report describes the potential, but unproven, role of the AstraZeneca COVID-19 vaccine in aTTP pathogenesis. Vaccineassociated aTTP can be successfully treated with plasma exchange, corticosteroids, and rituximab. [ABSTRACT FROM AUTHOR]

Breast cancer has recently been known as the first lethal malignancy in women worldwide. Despite the existing treatments that have improved the patients' prognosis, some types of breast cancer are serious challenges to treat. Therefore, efforts are underway to provide more efficient therapy. Cryptotanshinone (CPT) is a liposoluble diterpenoid derivation of a traditional Chinese herbal medicine called Salvia miltiorrhiza Bunge. It has been considered in the past decades due to its vast therapeutic properties, including anti-tumor, anti-inflammatory, and anti-fibrosis. Recently, studies have found that CPT showed a significant anti-breast cancer effect in vivo and in vitro through different physiological and immunological mechanisms. This study summarized the latest research findings on the antitumor effect of CPT in breast cancer. Further, the main molecular mechanisms based on breast cancer types and combination with other drugs were reviewed to provide essential evidence for future longitudinal research and its clinical application in breast cancer treatment., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Dalil, Iranzadeh and Kohansal.)