Clinical features, management and outcomes of pediatric pleural empyema: A retrospective, multicenter cross sectional study

Objectives:To evaluate clinical features,treatment strategies,and outcomes of pleural empyema for children who were treated at referral pediatric hospitals in 8 provinces of Iran.Methods:In this retrospective,multicenter cross sectional study,we retrospectively retrieved patients'data from 8 teaching hospitals during 2010 and 2017.A questionnaire was applied and filled,and all data were statistically and descriptively analyzed.Results:In total,191 children(109 males and 82 females)were included.Their mean age was 4.95 years and ranged from 11 months to 16 years.The majority of cases(45.1%)were 1-4 years old.Fever(70.3%),cough(65.6%),tachypnea(53.1%),chest pain(14.6%),and abdominal pain(12%)were the most common manifestations at admission.The mean length of admission in hospital was 16.4 d.Consequently,27 patients(14.1%)were admitted into the pediatric intensive unit because of severe illness,and 15 patients(7.9%)died.Logistic regression analysis showed that younger age(less than 12 months)and presence of underlying diseases(such as cardiovascular disease,immune deficiencies,malignancies,and neuro-developmental delay)significantly increased the mortality rate of patients with pleural empyema(P=0.004 and P=0.001,respectively).Conclusions:Pleural empyema children of younger age and with underlying diseases are at higher risks of death.In addition,guidelines for treating pleural empyema should be developed.

Pneumococcal meningitis in Iran: a systematic review and meta-analysis

Objective: To estimate the frequency of pneumococcal meningitis among patients with bacterial meningitis in Iran. Methods: PubMed, Embase, Web of Science and Scientific Information Database (www. sid.ir) were searched from 2000 to 2016 to identify studies on the frequency or prevalence of pneumococcal meningitis in Iran. Stata 14.0 (StataCorp, College Station, Texas, USA) was used to analyze the data. Results: Of the 131 records identified from the databases, 21 studies fulfilled the eligibility criteria. The analyses showed that 25.0% (95% CI: 19.0-32.0;I2=71%) of the confirmed bacterial meningitis (including children and adults) cases were caused by pneumococcus. Conclusions: The large fraction of meningitis cases caused by pneumococcus demonstrates that pneumococcal meningitis is a major public health problem in Iran, and the introduction of pneumococcal vaccines merits further attention from health authorities.

Unveiling the predictive power of bacterial response-related genes signature in hepatocellular carcinoma:with bioinformatics analyses and experimental approaches

Background:Despite progress in therapeutic strategies,treatment failure in hepatocellular carcinoma(HCC)remains a major challenge,resulting in low survival rates.The presence of bacteria and the host’s immune response to bacteria can influence the pathogenesis and progression of HCC.We developed a risk model based on bacterial response-related genes(BRGs)using gene sets from molecular signature databases to identify new markers for predicting HCC outcomes and categorizing patients into different risk groups.Methods:The data from the Cancer Genome Atlas(TCGA)portal was retrieved,and differentially expressed BRGs were identified.Uni-and multivariate Cox regression and least absolute shrinkage and selection operator(LASSO)LASSO analyses were executed to develop the prognostic risk model.Key contributor to the prognostic model was identified,and the results were tested by using experimental assays in HCC cell lines.Results:Multivariate analysis demonstrated an independent prognostic factor of 12-BRG signature in HCC patients.The low-risk group had better overall survival with significantly lower tumor mutation burden(TMB).The risk scores were negatively correlated with the presence of tumor-infiltrating immune cells.In an effort to find the key contributor of the 12-BRG signature,we found polo like kinase1(PLK1)had the best accuracy with 1-,3-,and 5-year AUC of 0.72,0.66,and 0.65,respectively.Both PLK1 inhibitor Volasertib and the knockdown of the PLK1 gene resulted in diminished viability in HCC cell lines.The combination of PLK1 inhibition with low-dose chemotherapy exhibited an amplified effect of the treatment.Conclusion:To date,there have been no reports of BRG biomarkers in HCC,and this study represents for the first time that a 12-BRG signature has the potential to predict the survival of HCC.