The existence of symbiotic relationships between Acanthamoeba and a variety of bacteria is well-documented. However, the ability of Acanthamoeba interacting with host bacterial pathogens has gained particular attention. Here, to understand the interactions of Escherichia coli K1 and E. coli K5 strains with Acanthamoeba castellanii trophozoites and cysts, association assay, invasion assay, survival assay, and the measurement of bacterial numbers from cysts were performed, and nonpathogenic E. coli K12 was also applied. The association ratio of E. coli K1 with A. castellanii was 4.3 cfu per amoeba for 1 hr but E. coli K5 with A. castellanii was 1 cfu per amoeba for 1 hr. By invasion and survival assays, E. coli K5 was recovered less than E. coli K1 but still alive inside A. castellanii. E. coli K1 and K5 survived and multiplied intracellularly in A. castellanii. The survival assay was performed under a favourable condition for 22 hr and 43 hr with the encystment of A. castellanii. Under the favourable condition for the transformation of trophozoites into cysts, E. coli K5 multiplied significantly. Moreover, the pathogenic potential of E. coli K1 from A. castellanii cysts exhibited no changes as compared with E. coli K1 from A. castellanii trophozoites. E. coli K5 was multiplied in A. castellanii trophozoites and survived in A. castellanii cysts. Therefore, this study suggests that E. coli K5 can use A. castellanii as a reservoir host or a vector for the bacterial transmission.
Acanthamoeba castellanii/*microbiology ; Animals ; Disease Reservoirs/*microbiology ; Disease Vectors ; Escherichia coli/growth & development/pathogenicity/*physiology ; Oocysts/microbiology ; Symbiosis/*physiology ; Trophozoites/microbiology

The pathogenesis and pathophysiology of Acanthamoeba infections remain incompletely understood. Phos-pholipases are known to cleave phospholipids, suggesting their possible involvement in the host cell plasma membrane disruption leading to host cell penetration and lysis. The aims of the present study were to determine phospholipase activities in Acanthamoeba and to determine their roles in the pathogenesis of Acanthamoeba. Using an encephalitis isolate (T1 genotype), a keratitis isolate (T4 genotype), and an environmental isolate (T7 genotype), we demonstrated that Acanthamoeba exhibited phospholipase A2 (PLA2) and phospholipase D (PLD) activities in a spectrophotometry-based assay. Interestingly, the encephalitis isolates of Acanthamoeba exhibited higher phospholipase activities as compared with the keratitis isolates, but the environmental isolates exhibited the highest phospholipase activities. Moreover, Acanthamoeba isolates exhibited higher PLD activities compared with the PLA2. Acanthamoeba exhibited optimal phospholipase activities at 37degrees C and at neutral pH indicating their physiological relevance. The functional role of phospholipases was determined by in vitro assays using human brain microvascular endothelial cells (HBMEC), which constitute the blood-brain barrier. We observed that a PLD-specific inhibitor, i.e., compound 48/80, partially inhibited Acanthamoeba encephalitis isolate cytotoxicity of the host cells, while PLA2-specific inhibitor, i.e., cytidine 5'-diphosphocholine, had no effect on parasite-mediated HBMEC cytotoxicity. Overall, the T7 exhibited higher phospholipase activities as compared to the T4. In contract, the T7 exhibited minimal binding to, or cytotoxicity of, HBMEC.
Acanthamoeba/*enzymology/genetics/*isolation & purification/physiology ; Cell Adhesion ; Cells, Cultured ; Endothelial Cells/parasitology ; Humans ; Keratitis/*parasitology ; Phospholipase D/genetics/*metabolism ; Phospholipases A2/genetics/*metabolism ; Protozoan Proteins/genetics/*metabolism ; Soil/*parasitology

Primary maternal infection with toxoplasmosis during pregnancy is frequently associated with transplacental transmission of the parasite to the fetus. This study was conducted to test the utility of PCR assay to detect recent infections with Toxoplasma in aborted women at various gestational ages who referred to Obstetrics and Gynecology Department of Alavi Hospital in Ardabil during 2014 and 2016. Two hundred women with a history of single or repeated abortion were investigated in this study. Blood samples were tested for specific anti-Toxoplasma IgM and IgG antibodies by ELISA. According to the results, 53.5% of the women under study were positive for anti-Toxoplasma antibodies: 4.0% of them had IgM, 43.0% had IgG, and 6.5% had both IgM and IgG. Subsequently, Nested-PCR analysis was used to detect T. gondii DNA in the placenta of subjects. In 10.5% of the women, the results were positive for 529 bp element of T. gondii. Among them, 5 (23.8%) cases were IgM positive, 1 (4.8%) case was IgG positive, and 11 (52.4%) were both IgM and IgG positive. In 4 (19.0%) patients, none of the antibodies were found to be positive. In total, 16 patients had positive results in both ELISA and PCR methods, and 174 cases had negative results for new infection. The findings of this study revealed that T. gondii might be one of the significant factors leading to abortion, and that the analysis of placenta can be important in order to achieve increased detection sensitivity.
Antibodies ; DNA ; Enzyme-Linked Immunosorbent Assay ; Female ; Fetus ; Gestational Age ; Gynecology ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Iran* ; Obstetrics ; Parasites ; Placenta* ; Polymerase Chain Reaction* ; Pregnancy ; Toxoplasma* ; Toxoplasmosis

Purpose:: Trauma may lead to serious complications in children patients. The purpose of this study was to investigate prognosis in children with traumatic injuries. Methods:: This cross-sectional study was conducted on all of the children (<18 years old) who had suffered traumatic injuries and transferred to the emergency department of Imam Hussein Hospital by emergency medical services. After selecting the children, a checklist including information such as demographic characteristics, trauma type, consciousness level, and final outcome was recorded. Finally, the data were analyzed using t-test, Chi-square test and ANOVA. Results:: In total of 564 children were investigated. Among them, 70% were males, and 33.2% were in the age range of 5-12 years. The mechanism of injuries in 97.9% of the cases was blunt trauma. The most common chief complaint among the affected children was nausea. The majority of them had stable vital signs and normal neurological tests results. However, 1.06% of them died during hospitalization. The results indicated that the final outcome in the children affected by traumatic injuries is significantly related to the type of trauma, the location of traumatic event, the vehicle used to transport them to emergency departments and their Glasgow coma scale score (p < 0.05). Conclusion: Considering the young age of the child patients and over half of trauma happened at home, it is important to raise parents' awareness about the risky places and activities, which were likely to result in traumatic injuries for children.

Introduction: Breast cancer is the most common cancer and it is the second leading cause of cancer mortality for women after lung cancer in Iran. Given the high prevalence of breast cancer, it is of crucial importance to determine reproductive risk factors of breast cancer. Methods: A total of 139 female patients suffering from breast cancer (the case group) and 279 healthy females (the control group) who were age-matched participated in the study over the period from March 2018 to March 2019. Demographic and reproductive variables, including the number of pregnancies, breastfeeding, history of oral contraceptive use, abortion history, age at first menstruation and age at first childbirth, were all recorded via survey. Conditional Logistic regression was employed to calculate OR (CI: 95%). Results: The mean age of breast cancer patients was 50.8 ± 8.31. First degree family history of breast cancer, History of oral contraceptive use and delaying first pregnancy drastically increased the chance of breast cancer whereas breastfeeding and menstruation after the age of 14 reduced the chance of breast cancer. Conclusion: The findings of this study reveal that the age at first birth, use of oral contraceptives, first degree family history of breast cancer and lack of breastfeeding have a significant relationship with breast cancer. Thus, women who have experienced such factors are susceptible to breast cancer and need to be prioritized for preventive treatments and screening.

Acanthamoeba is an opportunistic protozoan pathogen which is found in diverse environment worldwide. Being ubiquitous nature of this amoeba we come across it in our daily life. Acanthamoeba species are recognized as human pathogens; that may cause blinding keratitis and rare but fatal granulomatous encephalitis involving central nervous system. To date, there is not a single report in literature demonstrating anti-Acanthamoeba antibodies among the Saudi population, and thus aim of the present study. Using ELISA, we identified the antibody level in the local population. Our results represent the secretory IgA antiAcanthamoeba in mucosal secretions from 133 individuals aged 15–60 years. The antiAcanthamoeba antibody prevalence rate was > 80%, and no considerable differences were observed between prevalence in males (80.28%) and that in females (80.64%). In addition, environmental sources (soil and water) from the environment of the participants in our study were evaluated for amoeba incidence. The amoeba was identified by morphological characteristics of cysts or trophozoites on non-nutrient agar plates grown with E. coli. Overall, 58.75% of samples from water and 32.85% of those from soil were culture positive for outgrowth of amoeba on non-nutrient agar plates. Furthermore, PCR was carried out with genus-specific primers to confirm the presence of Acanthamoeba DNA. Our results revealed that about 68% of cultures from water and 43% of those from soil were successfully amplified and proved to be amoeba DNA. Interestingly, a few samples yielded more than one product, which suggests that some other amoebic species may be present in the same sample (MAC-W1 and MADW1). To the best of our knowledge, we described for the first time the amoeba isolation from the participant’s close environment and antibodies level among Saudi population. Our future studies will be focused on additional molecular characterization of isolated amoeba and their pathogenic potential which could be a possible threat for the community.

Recommendations for managing clinically localized prostate cancer are structured around clinical risk criteria, with prostate biopsy (PB) Gleason score (GS) being the most important factor. Biopsy to radical prostatectomy (RP) specimen upgrading/downgrading is well described, and is often the rationale for costly imaging or genomic studies. We present simple, no-cost analyses of clinical parameters to predict which GS 6 and GS 8 patients will change to GS 7 at prostatectomy. From May 2006 to December 2012, 1590 patients underwent robot-assisted radical prostatectomy (RARP). After exclusions, we identified a GS 6 cohort of 374 patients and a GS 8 cohort of 91 patients. During this era, >1000 additional patients were enrolled in an active surveillance (AS) program. For GS 6, 265 (70.9%) of 374 patients were upgraded, and the cohort included 183 (48.9%) patients eligible for AS by the Prostate Cancer Research International Active Surveillance Study (PRIAS) standards, of which 57.9% were upgraded. PB features that predicted a >90% chance of upgrading included ≥ 7 cores positive, maximum foci length ≥ 8 mm in any core, and total tumor involvement ≥ 30%. For GS 8, downgrading occurred in 46 (50.5%), which was significantly higher for single core versus multiple cores (80.4% vs 19.6%, P = 0.011). Biochemical recurrence (BCR) occurred in 3.4% of GS 6 upgraded versus 0% nonupgraded, and in GS 8, 19.6% downgraded versus 42.2% nondowngraded. In counseling men with clinically localized prostate cancer, the odds of GS change should be presented, and certain men with high-volume GS 6 or low-volume GS 8 can be counseled with GS 7-based recommendations.
Biopsy ; Humans ; Male ; Middle Aged ; Neoplasm Grading/statistics & numerical data* ; Neoplasm Recurrence, Local/pathology* ; Prostate/surgery* ; Prostate-Specific Antigen/blood* ; Prostatectomy ; Prostatic Neoplasms/surgery* ; Retrospective Studies ; Sensitivity and Specificity