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Due to the high morbidity and mortality of the coronavirus disease 2019 (COVID-19) in patients with malignancy, the necessity of vaccination in this group of patients became particularly important. Although a large number of studies have reported the safety of COVID-19 vaccination in multiple myeloma (MM) patients, the effect of the COVID-19 vaccine on MM relapse has not yet been reported. Here, we report a case of a possible association between relapse of MM and COVID-19 vaccination with Sinopharm®, an inactivated virus vaccine, in a patient with MM who has remained in complete remission for about 4 years. The MM relapse in the patient was diagnosed by both clinical findings and laboratory workup including serum protein electrophoresis, bone marrow aspiration, and biopsy. Despite this possible association between COVID-19 vaccination and MM relapse in the patient, given its importance in reducing mortality and having an acceptable safety profile, the COVID-19 vaccine should be administered to all cancer patients. However, careful monitoring and follow-up are recommended in patients with MM after COVID-19 vaccination.

Background: Case presentation: In this study, we presented an Iranian female with triple-negative breast cancer that developed acro-metastasis to the hand Conclusions: However, bone metastasis is the most common kind of neoplasm extension that we can witness in the breast cancer, acro-metastasis to the hand is an extremely rare kind of bone metastasis that we can expect.

Primary mediastinal germ cell tumors accounts for about 3%-15% of the mediastinal malignancies. Nonseminomatous tumors make a small percentage of germ cell tumors. Treatment of mediastinal choriocarcinoma includes initial systemic chemotherapy, followed by complete resection of all residual tumors. However, patients with nonseminomatous tumors have very poor prognosis.

Tumor lysis syndrome is caused by the massive lysis of tumor cells. It frequently occurs in rapidly proliferating malignancies and less often after solid tumor treatment. Spontaneous tumor lysis syndrome is extremely rare and only occurs in bulky, advanced, and metastatic tumors. Electrolyte abnormalities in tumor lysis syndrome could be life-threatening without prompt recognition and treatment. In this case, we present a spontaneous tumor lysis syndrome in a 22-year-old man with primitive neuroectodermal tumor. When managing bulky, advanced solid tumors, especially with liver metastasis, cautious observation should be sought because of the possibility of spontaneous tumor lysis syndrome.

Background: Busulfan (BU) in combination with cyclophosphamide (CY) is used as an effective conditioning regimen in hematopoietic SCT. Busulfan, depletes glutathione level in liver and causes elevated levels of CY metabolites. Cyclophosphamide metabolites are highly toxic for sinusoidal endothelial cells and cause VOD/ SOS with high mortality rate. Materials and Methods: All adult patients with acute leukemia, who were candidates for myeloablative allogenic SCT admitted in Stem Cell Transplantation center of our center were enrolled in this prospective randomized clinical trial during 2 years. We tested the hypothesis that reverse administration from BU-CY (28 patients) to CY-BU group (27 patients) would reduce liver toxicity. Results: Liver function tests were significantly higher in BU-CY group between day -1 and +4 (p

The standard therapy for thyroid cancer is total or near total thyroidectomy, followed by the administration of radioactive iodine for remnant ablation or residual disease. Patients with radioiodine therapy are predisposed to second malignant neoplasms in organs such as central nervous system (CNS), breast, prostate, kidney, bone marrow, salivary gland, and digestive tract. Exposure to carcinogen including occupational and therapy related hazard, aging and genetic susceptibility are other causes of second primary cancers. The second primary malignancies are not uncommon and, nowadays, the prevalence of it is mildly increasing due to the increasing survival of cancer patients and advances in early diagnosis and therapeutic modalities. Here, we present a fifty-one-year-old man with papillary thyroid carcinoma (PTC), who developed chronic lymphocytic leukemia (CLL), renal cell carcinoma (RCC), and basal cell carcinoma (BCC) in 15-20 years after radioactive iodine therapy. Second primary tumors are increasing and environmental, genetic susceptibility and increase in survival of cancer patients are the major risk factors.

Background: Hemodialysis (HD) patients are prone to infections as a result of impaired immune system. Early detection of disease helps to prevent complications. The aim of this study was to evaluate the prevalence of intestinal parasite infections in HD patients and compare it with control groups. Methods: In a cross sectional study, the stool sample of 155 HD patients, and 294 controls were examined for parasitic contaminations. Control groups included: 130 patients’ family, 16 staffs of three HD wards and 148 normal populations. 3 stool samples were taken from each participant. After perceiving the appearance of the samples and preceding the stages of concentration with Formaline-ether method, direct smear were prepared and inspected by trichrome staining. Then, groups were compared with SPSS version12 by chi-square and T-test methods. Results: 43.9% of 155 HD patients were infected by intestinal parasites. There was 40% parasite infection in non diabetic and 45% in diabetic case groups with no significant difference between the 2 groups (P>0.05). There was no relation between parasite infection with sex, HD duration and use of immunosuppressive drugs. 43.1% of control group was also infected. No significant difference was seen between the 2 groups (P>0.05).The most common parasite was Blastocystis hominis in the 2 groups. Conclusion: This study could not show increased parasite infection in HD patients compared to control groups. The high prevalence of intestinal parasites in HD patients and control groups, may indicate that population hygiene status is not well controlled, and emphasizes more health care providers’ attention.

Background: Limited studies have shown that the administration of Bromocriptine leads to clinical improvement in a number of rheumatic patients. Low price of Bromocriptine and its trivial side effects lead the authors to investigating the effect of Bromocriptine on rheumatoid arthritis (RA) disease activity. Methods: In a randomized controlled double-blinded quasi-experimental study the effectiveness of Bromocriptine in treating rheumatoid arthritis was evaluated. 80 patients were divided in two groups (experiment and placebo. The inclusion criteria were the presence of active rheumatoid arthritis (DAS > 3.2) in spite of medical treatment. In addition to the standard medications, the case group received single oral doses of 5 mg bromocriptine and the control group received placebo tablet and were followed up for three months. Independent T-test was used to compare DAS28 in the two groups. P < 0.05 was considered significant. Finding: The mean ages of the experiment and placebo groups were 46.2 ± 13.0 and 45.9 ± 12.5 respectively. Before the starting pf the intervention in the experiment group, the mean values of PRL and DAS were 11.7 ± 6.9 and 4.2 ± 1.2, and the mean values of PRL and DAS in the placebo group were 11.3 ± 6.2 and 4.6 ± 1.4 respectively (P > 0.05). After the intervention the mean values of serum PRL level and DAS in the experiment group were 10.6 ± 7.1 and 3.7 ± 1.3 respectively, that were different with those of before the intervention (P < 0.05). Conclusion: Our findings suggest that Bromocriptine might be effective in decreasing the rheumatoid arthritis disease activity index, without any concerns about side effects.

مقدمه: توليد آنتی‌بادی به علل مختلفی در بيماران دياليزی مختل است. راه‌های گوناگونی جهت بهبود پاسخ به واکسن هپاتيت B در اين بيماران وجود دارد. در این مطالعه درصدد برآمديم تا اثر واکسن دوگانه بر ميزان پاسخ‌دهی به واکسن هپاتيت B را بررسی کنيم. روش‌ها: 43 بيمار همودياليزي و 20 بيمار دياليز صفاقي که به يک دوره‌ی کامل واکسيناسيون هپاتيت B پاسخ نداده بودند، انتخاب شده و به دو گروه A (30 بيمار) و گروه B (33 بيمار) تقسیم شدند. واکسن هپاتيت B به ميزان چهل ميکروگرم در فواصل صفر، 1 و 6 ماه به بيماران تزريق شد. در گروه A هم‌زمان با دوز صفر، واکسن دوگانه نيز تزريق شد. در فواصل 1 تا 2 ماه و 6 ماه بعد از اتمام واکسيناسيون، سطح آنتي‌بادي برعليه هپاتيت B (HBS Ab) اندازه گيري شد. یافته‌ها: ميزان پاسخ به واکسن در بيماران گروه A، در ماه‌های اول 96 درصد در مقابل 9/83 درصد در بیماران گروه B (7/0 = P) و در ماه ششم 5/87 درصد در مقابل3/83 درصد (34/0 < P). پاسخ‌دهي به واکسن در بيماران مبتلا به هپاتيت C کمتر از بيماران غير مبتلا به هپاتيت C (02/0 = P) بود و در بيماران جوان بهتر از بيماران مسن به واکسیناسیون پاسخ داده بودند (005/0 = P و 339/0 = r). نتیجه‌گیری: تزريق واکسن دوگانه همراه با واکسن هپاتيت B تأثیری در تداوم پاسخ به واکسن هپاتيت B ندارد. ميزان پاسخ به واکسن در بيماران مسن کمتر از افراد جوان و در بيماران مبتلا به عفونت هم‌زمان هپاتيت C کمتر از افراد غير مبتلا به عفونت هپاتيت C است.

Background: The Hepatitis B (HB) vaccine response in hemodialysis patients is less than healthy individuals. Different strategies have been taken into account to improve the response rate. This study aimed to evaluate the effect of tetanus and diphtheria (Td) vaccine as an adjuvant therapy to HB vaccination. Methods: Sixty three end-stage renal disease patients were recruited on dialysis that were older than 18 years and had passed at least 3 doses of HB vaccination schedule, and had HBS antibody (Ab) with titer less than 10 IU/L. The patients were divided into two groups; A (30 patients) and B (33 patients). Both of the groups received a 3-dose HB vaccination schedule of 40 μ g intramuscularly in the left deltoid muscle at 0, 1 and 6 months. Group A also received Td vaccine intramuscularly simultaneous with the first dose of HB vaccine. HBS Ab was measured in periods of 1 and 6 months after completion of the vaccination. Results: One month after completion of the vaccination, group A had better but not significant response rate (96%) than group B (83.9%) (p > 0.05); in addition, after 6 month there was no difference between the two groups (87.5% vs. 83.3%) (p > 0.05). Patients with HCV infection had lower response rate than patients who did not have HCV infection (33.3% vs. 92.5%) (p < 0.05). Age had negative effect on immune response to HB vaccination (r = -0.339; p = 0.005). Conclusions: The use of Td vaccine concurrent with HB vaccination may increase the response rate in non-responder individuals; however, it seems it does not have any role in the persistence of immune response. Age and HCV infection negatively affected the response to HB vaccination in dialysis patients.

Background: Limited studies have shown that the administration of Bromocriptine leads to clinical improvement in a number of rheumatic patients. Low price of Bromocriptine and its trivial side effects lead the authors to investigating the effect of Bromocriptine on rheumatoid arthritis (RA) disease activity. Methods: In a randomized controlled double-blinded quasi-experimental study the effectiveness of Bromocriptine in treating rheumatoid arthritis was evaluated. 80 patients were divided in two groups (experiment and placebo. The inclusion criteria were the presence of active rheumatoid arthritis (DAS > 3.2) in spite of medical treatment. In addition to the standard medications, the case group received single oral doses of 5 mg bromocriptine and the control group received placebo tablet and were followed up for three months. Independent T-test was used to compare DAS28 in the two groups. P < 0.05 was considered significant. Findings: The mean ages of the experiment and placebo groups were 46.2 ± 13.0 and 45.9 ± 12.5 respectively. Before the starting pf the intervention in the experiment group, the mean values of PRL and DAS were 11.7 ± 6.9 and 4.2 ± 1.2, and the mean values of PRL and DAS in the placebo group were 11.3 ± 6.2 and 4.6 ± 1.4 respectively (P > 0.05). After the intervention the mean values of serum PRL level and DAS in the experiment group were 10.6 ± 7.1 and 3.7 ± 1.3 respectively, that were different with those of before the intervention (P < 0.05). Conclusion: Our findings suggest that Bromocriptine might be effective in decreasing the rheumatoid arthritis disease activity index, without any concerns about side effects. [ABSTRACT FROM AUTHOR]

BACKGROUND: The Hepatitis B (HB) vaccine response in hemodialysis patients is less than healthy individuals. Different strategies have been taken into account to improve the response rate. This study aimed to evaluate the effect of tetanus and diphtheria (Td) vaccine as an adjuvant therapy to HB vaccination. METHODS: Sixty three end-stage renal disease patients were recruited on dialysis that were older than 18 years and had passed at least 3 doses of HB vaccination schedule, and had HBS antibody (Ab) with titer less than 10 IU/L. The patients were divided into two groups; A (30 patients) and B (33 patients). Both of the groups received a 3-dose HB vaccination schedule of 40 [mu] g intramuscularly in the left deltoid muscle at 0, 1 and 6 months. Group A also received Td vaccine intramuscularly simultaneous with the first dose of HB vaccine. HBS Ab was measured in periods of 1 and 6 months after completion of the vaccination. RESULTS: One month after completion of the vaccination, group A had better but not significant response rate (96%) than group B (83.9%) (p > 0.05); in addition, after 6 month there was no difference between the two groups (87.5% vs. 83.3%) (p > 0.05). Patients with HCV infection had lower response rate than patients who did not have HCV infection (33.3% vs. 92.5%) (p < 0.05). Age had negative effect on immune response to HB vaccination (r = -0.339; p = 0.005). CONCLUSIONS: The use of Td vaccine concurrent with HB vaccination may increase the response rate in non-responder individuals; however, it seems it does not have any role in the persistence of immune response. Age and HCV infection negatively affected the response to HB vaccination in dialysis patients. [ABSTRACT FROM AUTHOR]

Background: Antibody production in patients with end-stage kidney disease impairs due to several mechanisms. There are different ways to improve response rate to Hepatitis B (HB) vaccine. In this study we evaluated the effect of Tetanus-diphtheria toxoid (Td) vaccine on HBS Antibody (Ab) level while being given simultaneously with HB vaccine. Methods: We recruited 43 hemodialysis and 20 peritoneal dialysis patients who had HBS Ab titer less than 10 IU/L after first schedule of HB vaccination. The patients were divided into two groups: A (30 patients) and B (33 patients). Both received 3 dose HB vaccination schedule of 40 μg intramuscularly in the left deltoid muscle at 0, 1 and 6 months while group A, received Td vaccine intramuscularly simultaneous with first dose of HB vaccine, too. HBS Ab was measured in periods of 1 and 6 months after completion of vaccination. Findings: Group A had better but not significant response rate than group B in one month (96% vs. 83.9%) (P = 0.07) and six months (87.5% vs 83.3%) (P = 0.34) after completion of vaccination. Patients with HCV infection had lower response rate than the ones who did not have HCV infection (33.3% vs. 92.5%) (P= 0.02). Response rate was better in younger patients (r= 0.339 and P= 0.005). Conclusion: The use of Td vaccine simultaneous with HB vaccination does not have any role in the persistence of immune response. Age and HCV infection negatively affect the response to HB vaccination in dialysis patients. [ABSTRACT FROM AUTHOR]