Reviews in Clinical Medicine

44-50

Authors: Kazem Anvari; Azam Anvari; Mehdi Silanian Toosi

Esophageal squamous cell carcinoma (ESCC) is one of the most frequent malignancies, worldwide. It is important to find out what prognostic factors can facilitate diagnosis, optimize therapeutic decisions, and improve the survival of these patients. Despite improvements in surgical techniques combined with chemotherapy and/or radiotherapy, the novel therapies such as small molecule inhibitors of tyrosine kinases (TKIs) and humanized monoclonal antibodies (mAbs) are very much needed. On the other hand, neoadjuvant chemotherapy which may improve the outcome is accompanied by toxicity by destruction of normal cells. Side effects may be avoided by developing therapies that specifically target molecular characteristics of tumors. Epidermal growth factor receptor (EGFR) is one of tyrosine kinases receptors widely distributed in human epithelial cell membrane. Genetic polymorphisms in EGFR genes influence cell cycle progression, angiogenesis, apoptosis and metastasis. EGFR mutations are mostly observed in lung tumors; curiously they are more prevalent in Asian women diagnosed with adenocarcinoma. Also, esophageal SCC shows a relatively high incidence of EGFR (33%) and/or HER2 (31%) overexpression. Patients who carry these mutations in EGFR have been founded tending to have a better response to gefitinib, an EGFR-TKI, whereas patients with the wild-type genotype show a better response to conventional chemotherapy. Therefore, finding clinical characteristics and environmental interactions with EGFR can affect on investigations about novel anti-cancer therapies like monoclonal antibodies and gene therapy and studies which identify patients who may benefit from EGFR targeted therapies. Hence, it may be effective on the improvement of prognosis in these patients.

57-60

Authors: Farhad Heidarian; Tahereh Ansarinezhad

One of the major causes of mortality in children younger than 5 years old is acute lower respiratory tract infections (ALRI). ALRI clinical features are cough, tachypnea, fever, coryza, chest retraction, crackles and wheeze. Increased white blood cell count with left shift might happen in pneumonia. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) might rise in children with respiratory tract infections. Vitamin A deficiency is associated with severe childhood infections. The effect of vitamin A supplementation in childhood pneumonia depends on the prevalence and the level of vitamin A deficiency in the population. Some studies confirmed that retinol levels were significantly higher after recovery from acute pneumonia compared to acute phase. But there were no significant association between serum retinol level and the clinical manifestation.

66-70

Authors: Samaheh Raftari; Morteza Saeedi

Although demyelination along the axons is the main manifestation of Multiple sclerosis (MS), peripheral nervous system (PNS) could be affected potentially too. In some studies PNS involvement is estimated to be more than 50 percent in MS patients. Accordingly, objective tests to confirm the severity of PNS involvement might be crucial in patients` management. Modern technological advances lead to innovation of computerized electrodiagnostic (EDX) techniques in recent years. Nerve conduction studies (NCS) provide reliable data about neuropathies. Although the frequency of PNS involvement varies in different population of MS patients, recognizing clinical and subclinical PNS impairments in MS patients is important for the treatment.

75-81

Authors: Navid Nourizadeh; Mohammad Reza Majidi; Amir Rezaei Ardani; Bashir Rasoulian; Fariborz Rezaeitalab; Hadi Asadpour; Kamran Khazaeni

One of the factors, which is involved in obstructive sleep apnea, is anatomic or inflammatory pathologies of nasal airway obstruction. Thus, it is logical to observe improvement of polysomnographic parameters of sleep-disordered breathing after nasal surgery. The authors performed a review of the literature, up to 2013, to determine the impact of nasal surgery on obstructive sleep apnea. Most current idea in this field is based on case series studies while randomized controlled trials evaluating the effect of surgery for nasal obstruction on sleep apnea are few and far between. According to these studies, surgery for nasal obstruction does not improve objective parameters of sleep apnea. Although nasal obstruction is one of the factors involved in obstructive apnea, one has to keep in mind that surgery will not result in major reduction of obstructive sleep apnea severity to relieve nasal obstruction. Detailed upper airway analysis has to be considered when surgery is an option for obstructive sleep apnea. Thus, nasal surgeries are beneficial when they are part of a multilevel approach in obstructive sleep apnea treatment.

86-92

Authors: Fereshteh Esmatinia; Mahdi bakhshaei

Nasal polyposis is one of the chronic airway diseases, which affects the patient’s quality of life in different ways. There are various complications along with nasal polyposis, which might be cured by drug administration. Due to failure of pharmacotherapy effects, various surgical approaches might be useful to resect the polyps with the possibility of polyposis recurrence after the surgery. In this study, we aimed to review different studies about the etiology and prevalence of recurrent nasal polyposis and the efficacy of endoscopic sinus surgery in reducing the incidence of recurrent nasal polyposis. We searched the PubMed and google scholar for the relevant articles. Based on the studied articles, there are various factors including the history of inflammatory diseases, the severity of polyposis, etc., which affect the long-term efficacy of surgical intervention.