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Key Clinical Message This pediatric case report underscores the importance of maintaining a high clinical suspicion for polyarteritis nodosa (PAN) in patients presenting with atypical features, such as migratory arthritis and subcutaneous nodules. Importantly, it highlights the focus on the potential relationship between streptococcal infection and cutaneous PAN. Early recognition and prompt, aggressive treatment is critical, as PAN can be a life‐threatening condition if left unmanaged. This case emphasizes the need for a multidisciplinary approach to effectively identify and manage this rare vasculitis disorder in the pediatric population. Abstract Polyarteritis nodosa (PAN) is a rare and life‐threatening vasculitis with diverse clinical presentations, posing a diagnostic challenge. Early recognition and prompt intervention are crucial to prevent organ damage. We present the case of an 8‐year‐old boy who exhibited atypical symptoms including migratory arthritis, myalgia, digital discoloration and ischemic changes, and subcutaneous nodules. Initial concerns for septic arthritis were ruled out. A comprehensive evaluation revealed elevated inflammatory markers and a confirmatory skin biopsy demonstrating active leukocytoclastic vasculitis, are highly suggestive of a diagnosis of PAN. Notably, elevated ASO titers suggested a possible concurrent streptococcal infection. The aggressive treatment approach with high‐dose aspirin, steroids, methotrexate, and tocilizumab is justified given the severity of the patient's symptoms and the nature of the disease process. This case underscores the importance of considering PAN in the differential diagnosis for children presenting with atypical features. Early diagnosis and prompt intervention, including addressing potential infectious triggers, are crucial for optimal outcomes in pediatric PAN.

Abstract Graphene‐based materials have shown immense pertinence for sensing/imaging, gene/drug delivery, cancer therapy/diagnosis, and tissue engineering/regenerative medicine. Indeed, the large surface area, ease of functionalization, high drug loading capacity, and reactive oxygen species induction potentials have rendered graphene‐ (G‐) and graphene oxide (GO)‐based (nano)structures promising candidates for cancer therapy applications. Various techniques namely liquid‐phase exfoliation, Hummer's method, chemical vapor deposition, chemically reduced GO, mechanical cleavage of graphite, arc discharge of graphite, and thermal fusion have been deployed for the production of G‐based materials. Additionally, important criteria such as biocompatibility, bio‐toxicity, dispersibility, immunological compatibility, and inflammatory reactions of G‐based structures need to be systematically assessed for additional clinical and biomedical appliances. Furthermore, surface properties (e.g., lateral dimension, charge, corona influence, surface structure, and oxygen content), concentration, detection strategies, and cell types are vital for anticancer activities of these structures. Notably, the efficient accumulation of anticancer drugs in tumor targets/tissues, controlled cellular uptake properties, tumor‐targeted drug release behavior, and selective toxicity toward the cells are crucial criteria that need to be met for developing future anticancer G‐based nanosystems. Herein, important challenges and future perspectives of cancer therapy using G‐ and GO‐based nanosystems have been highlighted, and the recent advancements are deliberated.

Heparin, usually isolated from porcine intestinal mucosa, is an active pharmaceutical ingredient of great material value. Traditionally, diverse types of commercial resins were employed as an adsorbent for heparin retrieval from biological samples. However, more recent years have encouraged the advent of new cost-effective adsorbents to achieve enhanced heparin retrieval. Inexpensive cationic ammonium-functionalized silica gels, monodispersed with larger surface area, porosity, and higher thermal stability, were chosen to evaluate the heparin recovery yield from porcine intestinal mucosa. We demonstrated that higher positively charged and less bulky quaternary modified silica gel (e.g., QDASi) could adsorb ~28% (14.7 mg g−1) heparin from the real samples. In addition, we also determined suitable surface conditions for the heparin molecule adsorption by mechanistic studies and optimized different variables, such as pH, temperature, etc., to improve the heparin adsorption. This is going to be the first reported study on the usage of quaternary amine-functionalized silica gel for HEP uptake.

Heparin is one of the most valuable active pharmaceutical ingredients, and it is generally isolated from porcine intestinal mucosa. Traditionally, different types of commercial resins are employed as an adsorbent for heparin uptake; however, using new, less expensive adsorbents has attracted more interest in the past few years to enhance the heparin recovery. Zeolite imidazolate framework-8 (ZIF-8), as a metal–organic framework (MOF) with a high surface area, porosity, and good stability at high temperatures, was selected to examine the heparin recovery. In this research, we demonstrate that ZIF-8 can recover up to ~70% (37 mg g−1) of heparin from porcine intestinal mucosa. A mechanistic study through kinetic and thermodynamic models on the adsorption revealed appropriate surface conditions for the adsorption of heparin molecules. The effect of different variables such as pH and temperature on heparin adsorption was also studied to optimize the recovery. This study is the first to investigate the usage of MOFs for heparin uptake.

Background and Objectives: Splenic hematoma is one of the common complications following abdominal blunt trauma, but non-traumatic splenic hematomas are not common and occurs in some cases, such as hematologic disorders and/or infections. Idiopathic splenic hematoma that occurs spontaneously without an underlying disease, is a rare occurrence, which its diagnosis needs strong clinical suspicion. Case report: The patient was a young man who referred to the emergency department with sustained lower abdominal pain during the past day. The pain aggravated by bending and was worsened by lying down. The patient reported no specific concomitant symptoms. His past medical history and drug history were negative. Chest x-ray and laboratory tests did not show any abnormal finding. In the upright radiograph of the abdomen, the shadow of the spleen seemed larger than the normal size. Abdominal sonography showed extensive subcutaneous hematoma of the spleen, which was confirmed by CT scan. The patient was under observation in the intensive care unit for 48 hours, that due to the pain intensification of the candidate, the splenectomy was performed. Pathologic study of splenic tissue was normal and he discharged within one week with satisfactory general health condition.

Background & aim: regarding the difference of opinion about the best position in percutaneous nephrolithotomy (PCNL), the aim of this study was to compare the efficacy, complications and patient satisfaction from percutaneous nephrolithotomy in prone and supine position under spinal anesthesia. Materials and methods: In the present clinical trial study, sixty patients candidate for PCNL were randomly divided into two equal groups. In the first group, the standard procedures was performed in the supine position and after turning the patients the prone position were preformed for second group. In both groups, in recovery after operation, the patients’ satisfaction from position during operation was checked by the Beck scale. Two weeks later, the patients were admitted and success was evaluated with ultrasound and KUB. Collected data were analyzed using the SPSS software. Results: Hospitalization duration in supine was 2/44±1/02 and for Peron was 2/12 ±0/56 days (p>0/05) respectively. The satisfaction level of supine position and the Peron position were 89.7 and 61.3 respectively. There was a significant differences was seen (p=0.018). The efficacy and cleanup of stones in both supine and prone were 69% and 58.4% respectively (p=0.19). Conclusion: PCNL in supine position is a safe procedure with similar efficacy compared to standard prone position for treatment of urolithiasis and patient satisfaction in this position is more although more studies with larger sample size is needed.

Bioconversion was utilized to conduct structural modification of the complex molecules FK-506 and ascomycin. Four interesting microbial reactions, regiospecific O-demethylation, glucosylation, hydroxylation, and phosphorylation, yielding various derivatives of the title compounds, were discovered from screening more than thousand microorganisms including bacteria, actinomycetes, and fungi. The isolated compounds were evaluated for a better understanding of structural and functional features responsible for their biological activity.