Kimia Mozahheb Yousefi

Abstract Background Chronic sinusitis is one of the most challenging health problems of contemporary society. Although several treatment methods have been defined, a comprehensive understanding of the underlying causes (e.g., antibiotic resistance) is still elusive. The aim of this study was to characterize two of the main extended-spectrum beta-lactamase genes—i.e., bla TEM and bla CTX-M genes—and investigate antimicrobial resistance in bacteria isolated from chronic sinusitis. Samples from 70 chronic sinusitis patients and 20 healthy individuals (controls) were analyzed for the presence of bla TEM and bla CTX-M resistance genes using the polymerase chain reaction (PCR) test, followed by gene sequence analysis. Results Phenotypic and genotypic beta-lactam resistance was observed in 58.7% and 61.54% of the gram-negative isolates, respectively, with 38.46% carrying the bla TEM gene and 34.62% harboring the bla CTX-M gene. Sequencing data indicated high heterogeneity in bla CTX-M genes (69–100% similarity to reported sequences) and lower heterogeneity in bla TEM genes (93–99%). Conclusion Broad-spectrum beta-lactam resistance is a major pathogenesis factor in chronic rhinosinusitis, and careful consideration is required for antimicrobial therapy. High bla CTX-M heterogeneity could mean high horizontal transfer rate of this gene and warrant a surveillance program.

Gastric cancer (GC) remains a significant global health burden, characterized by high mortality rates, often due to late-stage diagnosis, resistance to conventional therapies, and metastatic dissemination. This narrative review synthesizes current preclinical and early clinical evidence on the diverse roles of curcumin, a natural polyphenolic compound derived from Curcuma longa (turmeric), in the context of gastric cancer. A comprehensive search of databases, including PubMed, Scopus, and Web of Science, was conducted, and approximately 140 studies were critically appraised to identify mechanistic insights and translational barriers. In this context, curcumin’s potential in preventing GC is explored, specifically regarding its potent anti-inflammatory and antioxidant properties, modulation of precancerous lesions, and anti-Helicobacter pylori activity. Furthermore, the review details curcumin’s mechanisms in treating established GC, including its ability to inhibit cancer cell proliferation, induce apoptosis (via pathways like PI3K/Akt/mTOR, NF-κB, STAT3), and exert anti-angiogenic effects. Crucially, its capacity to inhibit GC metastasis by reversing epithelial-mesenchymal transition (EMT), suppressing matrix metalloproteinases (MMPs), and modulating key signaling pathways involved in invasion and migration is highlighted. Additionally, curcumin’s role in overcoming chemoresistance is discussed. Despite its promising pleiotropic actions, the clinical translation of curcumin is significantly challenged by its poor bioavailability. Moreover, various strategies to enhance systemic absorption are addressed, emphasizing the critical need for well-designed clinical trials to validate its efficacy and safety in human GC patients. This review underscores curcumin’s potential as a valuable complementary or integrative therapeutic agent in gastric cancer management.

Ketamine, a commonly used anesthetic, is known to induce hepatotoxicity mainly through elevation of serum liver enzymes. Rhus coriaria (sumac) possesses notable antioxidant properties; however, its therapeutic potential is hindered by poor bioavailability. This study aimed to evaluate the protective effects of sumac and its nanophytosome formulation against ketamine-induced liver injury in male mice. Twenty-five mice were randomly divided into five groups: control, nanophytosome control, ketamine <tex xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">$(20 \text{mg} / \text{kg})$</tex>, sumac-treated, and sumac-nanophytosome-treated. After 15 days, serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured. The synthesized sumac nanophytosomes were characterized for particle size and encapsulation efficiency. Ketamine administration significantly elevated ALT <tex xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">$(150 \pm 12 \mathrm{U} / \mathrm{L})$</tex> and AST <tex xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">$(180 \pm 15 \mathrm{U} / \mathrm{L})$</tex> compared with the control group (ALT <tex xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">$45 \pm 6$</tex>, AST <tex xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">$52 \pm 7$</tex>; <tex xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">$\mathrm{p}&lt;0.001)$</tex>. Treatment with sumac nanophytosomes markedly reduced these enzyme levels (ALT <tex xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">$68 \pm 9, p=0.002, \eta^{2}=0.62$</tex>; AST <tex xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">$92 \pm$</tex> 11, <tex xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">$\mathbf{p}&lt;0.001, \boldsymbol{\eta}^{2}=0.71)$</tex>, whereas the crude sumac extract showed a weaker effect (ALT <tex xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">$102 \pm 13$</tex>, AST <tex xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">$138 \pm 12)$</tex>. These findings indicate that sumac nanophytosomes exert substantial hepatoprotective effects against ketamine-induced liver injury, likely due to improved bioavailability and antioxidant capacity. This study highlights a promising nanotechnology-based strategy for mitigating drug-induced hepatotoxicity and provides the first direct comparison between crude and nanophytosome forms of sumac in this context.

INTRODUCTION: Antibiotic resistance is a critical global health issue, primarily driven by inappropriate antibiotic prescribing. Identifying reliable biomarkers to guide antibiotic use is essential to combat this challenge. Procalcitonin (PCT) testing has emerged as a promising tool for differentiating bacterial infections from non-bacterial conditions and supporting antibiotic stewardship programs. This literature review evaluates evidence from randomized controlled trials, observational studies, and real-world clinical data to assess the clinical utility of PCT testing in guiding antibiotic prescribing decisions. RESULTS: Across randomized controlled trials and real-world studies, PCT-guided algorithms typically yielded reductions in antibiotic duration of approximately 0.9 to 3 days in large adult cohorts, with some smaller or source-specific trials reporting reductions of up to 6 days. Relative decreases in antibiotic exposure varied widely across studies (ranging from approximately 8% to > 50%). Importantly, these reductions were achieved without increases in short-term or 28-day mortality, while hospital length of stay remained largely unchanged. Studies generally indicate that PCT-guided strategies are cost-effective, primarily driven by reduced antibiotic use. However, challenges such as interpretive difficulties, false-positive and negative results, and implementation barriers remain. CONCLUSION: Incorporating PCT testing into antibiotic stewardship strategies offers a promising approach to enhance prescribing accuracy, reduce antibiotic resistance risks, and improve patient care quality. Future research should focus on refining clinical guidelines, expanding applicability across diverse patient populations, and addressing practical challenges to facilitate widespread adoption of PCT testing in routine clinical settings.