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Iraj Nazari,1 Seyyed Masoud Mousavi,1 Ahmad Sadeghpour,1 Seyyed Mansour Alamshah,1 Maryam Dastoorpoor2 1Department of General Surgery, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; 2Department of Biostatistics and Epidemiology, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranCorrespondence: Ahmad SadeghpourDepartment of General Surgery, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranEmail dr.ahmadsadeghpour@gmail.comBackground: Occlusive lesions of superficial femoral artery (SFA) in endovascular candidate patients are treated with balloon angioplasty with or without stenting. Recently, introduction of drug-coated balloon (DCB) angioplasty as a superior treatment option to plain balloon (PB) has been challenging.Objective: The purpose of this study was to compare the effectiveness of DCB versus PB angioplasty in chronic lower extremity ischemia patients.Patients and Methods: In this clinical trial, 2 groups were matched at baseline; among 68 patients with peripheral artery disease, 23 patients were treated by DCB and 45 by PB. They were followed up for 6 months. Our findings of ABI, Rutherford and WIFI class changes, mortality, limb amputation, re-intervention and primary patency (PP) were collected and analyzed in comparative fashion between 2 groups.Results: Mean patients age was 68.5 years (77.9% male). At 6 months, the increase in ABI in DCB was 0.37 and in PB was 0.32 (P> 0.05). Mean decrease in Rutherford class in DCB and PB were 2.56, 2.28 (P> 0.05). Mean decrease in WIFI class in DCB and PB were 1.48, 1.11 (P> 0.05). In DCB group, 1 (4.3%) limb amputation, 3 (13%) re-interventions and no mortality with 87% PP were seen. In PB group, 2 (4.4%) limb amputation, 7 (15.6%) re-interventions, 1 (2.2%) mortality with 84.4% PP were seen.Conclusion: Treatment of occlusive lesions of SFA with DCB probably may leads to improvement in ABI, Rutherford and WIFI class, higher pp and lower rate of re-interventions. Since Rutherford class and pp in DCB group have improved during 6 months compared to 1 month follow up (in our study), this improvement seems to be more significant statistically in longer term of follow up.Keywords: angioplasty, drug-coated balloon; DCB, paclitaxel, peripheral vascular disease

Background: Popliteal artery pseudoaneurysm is a state of vascular wall rupture in the popliteal artery. It is generally a rare situation and the most common etiologic factor is iatrogenic causes., Case Presentation: This case report presents a successful diagnosis and management of a 31-year-old patient who was presented with a mass behind the knee, three months after femoropopliteal bypass for the treatment of a gunshot to the knee. An endovascular approach using coils was utilized for the patient, which led to complete remission for the patient., Discussion: The current patient had two primary therapeutic challenges: bleeding and hematoma growth, clot development causing blood flow restriction, and limb ischemia. Pseudoaneurysm also caused internal inflammation, which increased the risk of thrombosis and bypass graft damage during open surgery. Due to the risk of recurrence and graft damage, ultrasound-guided compression was not possible. Thus, endovascular therapy was preferred., Conclusion: The endovascular approach using coils is an option for the management of PAP. However, the endovascular approach should be considered carefully according to the patient's status., Competing Interests: Declaration of competing interest The authors have no conflict of interest to declare., (Copyright © 2024. Published by Elsevier Ltd.)

People with HIV (PWH) are at elevated risk for cardiovascular diseases (CVDs), including myocardial infarction, heart failure, and sudden cardiac death, among other CVD manifestations. Chronic immune dysregulation resulting in persistent inflammation is common among PWH, particularly those with sustained viremia and impaired CD4+ T cell recovery. This inflammatory milieu is a major contributor to CVDs among PWH, in concert with common comorbidities (such as dyslipidemia and smoking) and, to a lesser extent, off-target effects of antiretroviral therapy. In this review, we discuss the clinical and mechanistic evidence surrounding heightened CVD risks among PWH, implications for specific CVD manifestations, and practical guidance for management in the setting of evolving data., Competing Interests: The authors declare no relationships with industry relevant to this work and no conflicts of interest.

Introduction: Oxford Nanopore Technologies (ONT) is a third generation sequencing approach that allows the analysis of individual, full-length nucleic acids. ONT records the alterations of an ionic current flowing across a nano-scaled pore while a DNA or RNA strand is threading through the pore. Basecalling methods are then leveraged to translate the recorded signal back to the nucleic acid sequence. However, basecall generally introduces errors that hinder the process of barcode demultiplexing, a pivotal task in single-cell RNA sequencing that allows for separating the sequenced transcripts on the basis of their cell of origin. Methods: To solve this issue, we present a novel framework, called UNPLEX, designed to tackle the barcode demultiplexing problem by operating directly on the recorded signals. UNPLEX combines two unsupervised machine learning methods: autoencoders and self-organizing maps (SOM). The autoencoders extract compact, latent representations of the recorded signals that are then clustered by the SOM. Results and Discussion: Our results, obtained on two datasets composed of in silico generated ONT-like signals, show that UNPLEX represents a promising starting point for the development of effective tools to cluster the signals corresponding to the same cell., Competing Interests: TL received reimbursement of expenses from ONT to speak at an event. 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 © 2023 Papetti, Spolaor, Nazari, Tirelli, Leonardi, Caprioli, Besozzi, Vlachou, Pelicci, Cazzaniga and Nobile.)

Myeloid neoplasms (MN) are heterogeneous clonal disorders arising from the expansion of hematopoietic stem and progenitor cells. In parallel with genetic and epigenetic dynamics, the immune system plays a critical role in modulating tumorigenesis, evolution and therapeutic resistance at the various stages of disease progression. Single-cell technologies represent powerful tools to assess the cellular composition of the complex tumor ecosystem and its immune environment, to dissect interactions between neoplastic and non-neoplastic components, and to decipher their functional heterogeneity and plasticity. In addition, recent progress in multi-omics approaches provide an unprecedented opportunity to study multiple molecular layers (DNA, RNA, proteins) at the level of single-cell or single cellular clones during disease evolution or in response to therapy. Applying single-cell technologies to MN holds the promise to uncover novel cell subsets or phenotypic states and highlight the connections between clonal evolution and immune escape, which is crucial to fully understand disease progression and therapeutic resistance. This review provides a perspective on the various opportunities and challenges in the field, focusing on key questions in MN research and discussing their translational value, particularly for the development of more efficient immunotherapies., 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 Caprioli, Nazari, Milovanovic and Pelicci.)

Background: This study was designed to determine the frequency of hydatidosis in Khuzestan Province, Iran and to evaluate the antibody changes in infected individuals after treatment., Methods: Overall, 454 sera were collected from health centers of Khuzestan Province, southern Iran (from 2013 to 2018). Demographic data such as age, gender and history of disease were recorded. Serum samples were investigated for antibody against CE by ELISA using antigen B. Thirty six of cases were followed up after treatment., Results: Among the 454 evaluated cases, antibody against CE was detected in 184 (40.52%) including 115 (62.5%) females and 69 (37.5%) males. Age distribution was from 8-97 yr, the highest prevalence of hydatid cyst was observed in age group 40-49 years. Liver was the most infected organ (76.63%). Relapse of CE occurred in 23 of patients. In the majority of patients the antibody decreased, whereas in some cases increased CE antibody observed during post-treatment follow up., Conclusion: Current study indicated the high prevalence of hydatidosis and rate of relapse after treatment among suspected patients. Therefore, long periods and regular follow-up of patients after treatment is necessary and for these monitoring, antibody assay can be an appropriate method., Competing Interests: Conflict of interest The authors declare that there is no conflict of interest., (Copyright © 2021 Rafiei et al. Published by Tehran University of Medical Sciences.)

Aims: This study was done to assess the risk factors associated with diabetic foot ulcer-free survival in patients with diabetes., Materials and Methods: Based on a prospective cohort study, ADFC (Ahvaz Diabetic Foot Cohort) study, carried out in a university hospital, all of the patients with diabetes were followed up for new diabetic foot ulcer (DFU). The time of ulcer development was final outcome during two years in the present study. To analyze the data, the variables were first evaluated by univariate analysis. Subsequently variables with P value <0.2 were tested in multivariate analysis, using backward elimination multiple Cox regression., Results: From among 605 eligible patients of ADFC study, 566 patients without foot ulcer were included for a 2- years follow-up. Thirty subjects (5.3%) developed DFU during the study course none of whom underwent amputation. The DFU-free survival rate was 0.945 over two years of follow-up. In final multivariate Cox regression analysis, the variables which remained in the model and had a statistically significant relationship with time to develop foot ulcer were: dyslipidemia, history of DFU or amputation, nephropathy callus formation in the feet and diabetes duration. Foot deformity and patients' training about self-care of their feet were statistically borderline significant., Conclusions: The DFU-free survival rate was 0.945 over two years of follow-up. In this study, independent risk factors associated with ulcer-free survival in diabetic foot patients were dyslipidemia, prior history of DFU or amputation, diabetic nephropathy, callus formation in the feet and diabetes duration., (Copyright © 2018. Published by Elsevier Ltd.)

Aims: The aim of this study was to evaluate the prevalence of diabetic foot ulcer and its related risk factors., Materials and Methods: In this descriptive cross-sectional study, 605 patients with diabetes were evaluated in July 2014. A checklist was used to obtain demographic data, diabetes related data, past medical history, and physical examination data., Results: The prevalence of diabetic foot ulcer was 6.4% (95% CI: 4.64-8.73). Seventeen cases of them were female (4.9%). In univariate analysis, the following variables had statistically significant relationship with DFU prevalence: diabetes duration, educational level, 10 g monofilament sensation, Ankle Brachial Index (ABI) and Body Mass Index (BMI). Patients' age, glycemic control and smoking did not show any significant relationship with DFU. After logistic regression analysis, the patients with decreased 10 g monofilament sensation had DFU more than patients with normal sensation (OR = 8.84, 95% CI: 3.5-22.3). Abnormal ABI increased the odds of DFU (OR = 5.6, 95% CI: 1.3-24.18). The DFU prevalence in patients with diabetes duration of 11-20 years, was more than patients with ≤5 years (OR = 3.8, 95% CI: 1.33-10.8).The odds of DFU development in educated patients compared with illiterate patients was 0.27(95% CI: 0.12-0.57). BMI had a significant relationship with DFU prevalence. The odds in overweight patients was 0.259(95% CI: 0.108-0.623) and in obese patients was 0.263 (95% CI: 0.1-0.687)., Conclusion: The prevalence of DFU was 6.4% in this study. Final associated risk factors of DFU were decreased 10 g monofilament sensation, abnormal ABI, diabetes duration, educational level and BMI., (Copyright © 2018. Published by Elsevier Ltd.)

Aim/introduction: This study was carried out to assess the incidence and risk factors of diabetic foot ulcer (DFU)., Materials and Methods: In this prospective cohort study in a university hospital, all the participants were examined and followed up for new DFU as final outcome for two years. To analyze the data, the variables were first evaluated with a univariate analysis. Then variables with P value < 0.2 were tested with a multivariate analysis, using backward-elimination multiple logistic regression., Results: Among 605 patients, 39 cases had DFU, so we followed up the remaining 566 patients without any present or history of DFU. A two-year cumulative incidence of diabetic foot ulcer was 5.62% (95% CI 3.89-8.02). After analysis, previous history of DFU or amputation [OR = 9.65, 95% CI (2.13-43.78), P value = 0.003], insulin usage [OR = 5.78, 95% CI (2.37-14.07), P value < 0.01], gender [OR = 3.23, 95% CI (1.33-7.83), P value = 0.01], distal neuropathy [OR = 3.37, 95% CI (1.40-8.09), P value = 0.007], and foot deformity [OR = 3.02, 95% CI (1.10-8.29), P value = 0.032] had a statistically significant relationship with DFU incidence., Conclusion: Our data showed that the average annual DFU incidence is about 2.8%. Independent risk factors of DFU development were previous history of DFU or amputation, insulin consumption, gender, distal neuropathy, and foot deformity. These findings provide support for a multifactorial etiology for DFU.

Aim of the Study: We aimed to determine the pattern of drug use and the affective demographic factors in addicts in self-referred drug rehabilitation centers in Khuzestan province., Material and Methods: It was a cross-sectional descriptive and analytic study which has done on 4400 addicts in self-referred drug rehabilitation centers in Khuzestan province from March 2014 to March 2015. The collected data were analyzed in SPSS version 22 software. Mean and standard deviation were calculated for continuous variables and the frequency and percentage frequency were calculated for nominal and classified variables, and also t-test, χ2 and ANOVA were used to examine the relationships between variables. The level of significance was considered less than 0.05., Results: Finding has shown that 97.5% were male. The average age of subjects was 38.21 ±10.52. Most consumable drug in these people was opium (50.6%) and the main way of drug use was smoking (69.4%). In terms of motivation of using drug, in men were enjoyment and in women family problems had the highest relative percentage. The majority of subjects (67.2%) had a history of drug abandonment. The reason of referring to rehabilitation centers for treatment, types of using drug and the number of drug using, was significant difference between males and females (p < 0.05)., Conclusions: The results have shown that it is necessary to consider some issues including of provincial drug policy and increasing awareness at different levels of society and making appropriate cultural and sports spaces in order to achieve the primary preventive goals.

Unlabelled: Despite significant advances in the treatment of diabetic foot ulcers and below-the-knee critical ischemia, there are ongoing efforts to achieve a method with low complication, high success rate and persistence of long-term effects. The aim of the study was to examine the outcome of angioplasty in patients with below-the-knee critical ischemia referred to Hospital., Material and Methods: This semi-experimental study conducted on diabetics patients treated with PTA (Percutaneous transluminal angioplasty) with critical ischemia of lower limbs referred to Sina Hospital. After discharge, the patients were followed weekly for the first month and then monthly up to 12 months. The procedure short-term effects were examined through evaluation of wound healing as well as patients' recovery and pain relief, after one month. Given the distribution type, parametric and non-parametric test were used to compare the results before and after treatment. Pearson's correlation coefficient was used to determine the correlation between variables., Results: Twenty four patients participated in this study. The mean ankle-brachial index (ABI) at baseline was 0.55 ± 0.17. A month after angioplasty, the index increased statistically significant to 0.93 ± 0.16. The mean health score expressed by the patients at baseline was 5.48 ± 1.39. A month after angioplasty, it was significantly increased (6.32 ± 1.24). The mean pain score before enrollment was 6.68 ± 2.52 (according to VAS scale). There was a significant decrease over time (3.45 ± 1.13). The overall mean score of all patients at Rutherford Classification was 3.88 ± 0.63 at baseline. During the 1st month and 6th month follow-up, it was changed to Class 0 that was statistically significant in the first month., Conclusions: This study represents the mid-term outcomes of PTA. Although PTA treatment was associated with improved pain scores, satisfaction with health, classification of limb ischemia and diabetic foot ulcers, the effects only remain short-term and mid-term. However, long-term efficacy of PTA needs to be investigated further.

This study describes two cases of cervical sympathetic schwannoma operated at department of vascular surgery and review the literature to clarify the demographic, diagnostic, and therapeutic features of these rare lesions for the first time. Two 32- and 59-year-old ladies both presenting with a painless cervical mass were referred to our service with the initial diagnosis of carotid body tumor. At the operation, mobile masses which could be easily dissected from the surrounding arteries and veins, except for the cervical sympathetic trunk were observed. Micro-surgical techniques helped us with removing the lesions with saving the sympathetic trunk in both cases. No permanent deficits were observed post-operatively in patients. Angiographic studies can provide the only pre-operative clues to diagnose a sympathetic schwannoma. Total removal of the lesion at the expense of sacrificing the sympathetic nerve is associated with minimal neurologic deficits which are well tolerated by the patient.

Aim of the Study: was to comparison between internal jugular vs. subclavian vein cuffed tunnel catheter placement for dialysis., Material and Methods: Cases who required central venous catheter for dialysis were included in this study. Forty cases were included in this study and divided to two groups. Catheters were placed randomly in internal jugular vein or subclavian. Patients were followed for 6 months. Early and late complications of catheter's placement were recorded. Analysis was done using Spss ver 13.0 (Chicago, IL, USA)., Results: There were no significant differences between subclavian and internal jugular vein regarding occurrence of infection resulted in extraction or treatment. Also there were no significant differences regarding occurrence of thrombosis resulted in extraction or treatment. Failure rate was significantly higher in cases with internal jugular vein catheter compared to cases with subclavian vein catheter (p=0.04)., Conclusion: Failure rate was significantly higher in cases with internal jugular vein catheter compared to subclavian cathether. Subclavian catheter is more appropriate route for catheter placement.

Carotid body tumors (CBTs) are rare, slow-growing tumors that should be considered in evaluating every lateral neck mass. This single center study was performed to define demographic features, clinical characteristics and remedies of Iranian patients with CBT. A retrospective review of prospectively collected data was done on 45 patients with 50 CBTs who have been referred to Sina Hospital, Tehran, Iran, during a 10-year period, were investigated in this study. The demographic characteristics, clinical and pathologic features, imagings, preoperative treatments, surgical approach and complications were analyzed. The study group predominantly consisted of females (82%). Age of diagnosis was 18 to 75 years old. Five patients had bilateral CBT. Family history of CBT was positive in seven patients. Most of CBTs were ≤ 3cm in size. All of the patients presented with a neck mass, mostly without pain (84%). Other symptoms included vertigo 4%, dysphasia 4% and tinnitus 2%. There was no patient with cranial nerve involvement at presentation. The most common imaging helping the diagnosis was color Doppler sonography. Three patients had preoperative embolization. All patients underwent surgery and seven patients had post-operative cranial nerve injury. Nine cases underwent external carotid artery ligation and four ones had external carotid repair. Post operative mortality rate was one patient. This study provides epidemiological data on patients with CBT in Iran, which could be useful for health care workers in prompt diagnosis and appropriate work ups for patient's families in bilateral CBTs.

Objective: To determine potential factors that may result in motivating the youths to adopt smoking behaviour., Method: This cross-sectional study was conducted on 210 smoking and 217 non-smoking youths, aged 12-20 years., Results: The average age of starting cigarette and water pipe smoking was 14.5 +/- 2.4 and 11.2 +/- 1.5 years, respectively. The first experience with water pipe occurred mostly in the traditional teahouses for girls (54.8%), and in family parties (48.2%) for boys. In both genders, the first place of cigarette smoking was at friends' parties (56.8% for boys, and 52.1% for girls) and then followed by traditional teahouses (43.2% for boys, and 47.9% for girls). The most common reasons youths have picked up cigarette smoking were mainly to attract attention from friends, family inattention and poverty. Meanwhile, nearly all water pipe smokers reported using it for fun. The strongest predictors of smoking among boys were respectively father's occupation, having a smoking mother, and the number of smoking peers, whereas among girls, these factors were respectively having a smoking mother, frequenting traditional teahouses, and the number of smoking peers. Lower education of fathers and divorce among parents increased the probability of smoking in both genders, especially girls. School/work failure, as well as troubled relationship with parents and siblings were the other significant predictors of smoking in both genders, notably in girls., Conclusion: Public health control measures should be adopted not only to curtail cigarette use, but also to address water-pipe use. Preventive measures should be regarded as a high priority for socio-economically disadvantaged families.

Objectives: To determine the national prevalence of smoking among Iranian youths and its environmental influencing factors., Methods: This study was performed in 2003-2004 among 11,966 school students, ages 11-18 years, selected by multi-stage random cluster sampling from 20 provinces in Iran. The participants filled out self-administered anonymous questionnaires., Results: The prevalence of self-reported cigarette smoking was 14.3%, with a higher prevalence in boys than in girls (18.5% vs. 10.1%, respectively, P < 0.001), and in high school than in middle school students (17.4% vs. 10.6%, respectively, P < 0.001). Overall, 42.2% of smokers were daily smoker, and the rest were occasional smoker. The mean age of the first attempt to smoke was 13.2 +/- 2.5 years with no significant gender difference but was significantly lower in daily than in occasional smokers. The place of the first attempt to smoke was mostly in friend parties (41.6%) and traditional teahouses (23.2%) for boys and the family parties (37.1%) and the traditional teahouses (27.4%) for girls. The higher school level and having a tobacco user at home significantly increased the likelihood of smoking in adolescents, with the highest odds ratio (OR) found for having a smoker sister in girls (OR = 4.5, 95%CI, 2.5, 8.2), and having a smoker brother in boys (OR = 2.4, 95%CI, 2.03, 3.05)., Conclusion: Smoking is becoming as a major public health threat among Iranian youths. Control measures should be considered not only for cigarette smoking, but also for the socially accepted habit of water pipe use that is revived in traditional teahouses.