Breast cancer-related lymphedema (BCRL) is a debilitating condition that affects a significant proportion of breast cancer survivors, profoundly impacting their quality of life. While many studies have investigated the risk factors for BCRL occurrence, the determinants of its severity remain underexplored. This retrospective observational study evaluated the risk factors associated with BCRL severity among patients treated at the Motamed Cancer Institute, Tehran, Iran. Female patients with unilateral BCRL aged 25–75 years were included. Data were collected over a 10-year period and analyzed for demographic, clinical, and pathological variables. Lymphedema severity was assessed using established clinical staging criteria and categorized into early-stage (stages 1 and 2a) and advanced-stage (stages 2b and 3) groups. Also, presence of fibrosis and non-pitting edema were other indicators of BCRL severity. Statistical analyses included univariate and multivariate logistic regression to identify predictors of advanced-stage BCRL. A total of 500 participants were analyzed, with a mean age of 41.16 ± 10.20 years and BMI of 28.72 ± 4.78 kg/m². Advanced-stage BCRL was significantly associated with older age (p = 0.00), higher number of excised lymph nodes (p = 0.04), and radiotherapy (p = 0.00). Multivariate analysis identified radiotherapy as the strongest independent predictor of advanced-stage BCRL (OR: 2.12, 95% CI: 1.22–3.67, p = 0.007). Other variables, including tumor grade, molecular subtypes, and type of surgery, did not independently predict BCRL severity. Advanced-stage BCRL is influenced by multiple factors, particularly radiotherapy and the extent of lymph node dissection. These findings underscore the importance of strategies to mitigate risk among breast cancer survivors, especially those undergoing radiotherapy. Further research is warranted to explore targeted interventions for reducing BCRL severity.

Background: Breast cancer survivors (BCSs) often face long‐term complications, with upper‐limb lymphedema and cancer‐related fatigue (CRF) being challenging. This study aimed to investigate the relationship between upper‐limb lymphedema and fatigue among BCSs.Method: This cross‐sectional study was performed on 102 BCSs, of which 31 (30.4%) had breast cancer–related lymphedema. Duration, stage, and excess volume were considered as indicators of breast cancer–related lymphedema severity. QoL was measured using the EORTC QLQ‐C30. The score of the fatigue symptom scale was used based on EORTC QLQ‐C30 for CRF assessment. Also, the brief fatigue inventory was used to measure the severity of fatigue among participants.Results: The mean fatigue symptom scale and brief fatigue inventory scores were 37.90 ± 24.59 and 3.69 ± 1.25, respectively. The mean fatigue symptom scale was significantly different among BCSs with BMI ≤ 25 and BMI > 25 (29.59 ± 24.49 vs. 41.51 ± 23.88, p = 0.026). Also, the mean brief fatigue inventory was significantly different among BCSs with the number of dissected lymph nodes (LNs) ≤ 5 and > 5 (3.52 ± 1.18 vs. 4.08 ± 1.34, p = 0.042). Additionally, women with breast cancer–related lymphedema had significantly higher scores of fatigue symptom scale and brief fatigue inventory (46.59 ± 27.12 vs. 34.11 ± 22.56, p = 0.03, and 4.75 ± 1.21 vs. 3.22 ± 0.96, p = 0.001, respectively). Except for a weak correlation between BMI and fatigue symptom scale and brief fatigue inventory (r: 0.279, p = 0.004, and r: 0.313, p = 0.001, respectively), there was no other significant relationship between CRF and study variables such as breast cancer–related lymphedema duration, stage, and excess volume. Meanwhile, fatigue symptom scale and brief fatigue inventory were significantly correlated with global health and functional scale scores of EORTC QLQ‐C30. The ROC curve which models the diagnostic efficacy for fatigue symptom scale showed an AUC of 0.634 (p = 0.034, 95% CI: 0.510–0.759), while the ROC curve which models the diagnostic efficacy for brief fatigue inventory showed an AUC of 0.821 (p < 0.001, 95% CI: 0.735–0.908).Conclusion: This study highlighted that while breast cancer–related lymphedema was associated with increased CRF, the severity of lymphedema did not significantly correlate with CRF. Additionally, CRF might be an indicator of breast cancer–related lymphedema among BCSs.

Cytokeratins are intracellular proteins known as diagnostic biomarkers or prognostic factors for certain cancers. Cytokeratin 19 (CK-19) expression has been proven to have prognostic value for some cancers, but its relationship with others, such as prostate cancer (PCa), remains unclear. This systematic review article aimed to examine the relationship between CK-19 expression and prostate adenocarcinoma (PAC). To include the eligible studies that detected CK-19 expression in PAC, published articles since June 2024 were found using PubMed, Scopus, and Web of Science databases. The “prostate cancer” and “cytokeratin 19” keywords and their Mesh term were used for search databases. Data from the included articles were extracted and tabulated. This study was performed using the PRISMA guidelines, and the JBI checklist was used for the quality assessment. The study protocol was registered in PROSPERO under the “CRD42023472637” code. Twenty-one studies were included. Eleven studies used reverse transcription polymerase chain reaction (RT-PCR) to investigate CK-19 expression, four used immunohistochemistry (IHC) staining, three used both one-step nucleic acid amplification (OSNA) and hematoxylin and eosin (H&E) methods, and three used the electrochemiluminescence (ECL) technique. CK-19 expression was detected in 301 patients among 619 patients. Additionally, only five out of 80 healthy donors were positive for CK-19 expression. Available evidence indicates a correlation between CK-19 expression and PAC progression, with higher CK-19 levels associated with advanced stages and worse prognosis. The overall evidence suggests that CK-19 could serve as a diagnostic and prognostic marker in PAC.

Carpal tunnel syndrome (CTS) is a common neuropathy caused by median nerve compression, leading to pain, numbness, and functional impairment. While surgical decompression remains the definitive treatment for severe cases, non-surgical approaches are often utilized for symptom management. Lymphatic drainage techniques, including manual lymphatic drainage (MLD) and Kinesio taping, have been proposed as potential therapies for CTS by reducing edema and nerve compression. However, their efficacy remains uncertain. This study aimed to evaluate the effects of lymphatic drainage techniques on symptom severity, functional outcomes, nerve conduction parameters, and pain relief in patients with CTS. This meta-analysis was conducted following PRISMA guidelines. A comprehensive search of PubMed, Scopus, and Web of Science databases was performed up to February 2025. Studies assessing the effects of lymphatic drainage techniques (MLD, Kinesio taping, or compression therapy) on CTS-related outcomes were included. Two meta-analytical approaches were used: (1) between-group differences comparing intervention and control groups and (2) within-group changes pre- and post-intervention. Primary outcomes included the Boston Symptom Severity Scale (BSSS), Boston Functional Status Scale (BFSS), Visual Analog Scale (VAS), median nerve cross-sectional area (CSA), hand grip strength, and nerve conduction studies. Twelve studies met the inclusion criteria, with a total of 479 participants. The between-group meta-analysis revealed significant pain reduction (VAS: SMD = -0.31, 95% CI: -0.51 to -0.12, p < 0.05) and improvements in CSA (SMD = 0.39, 95% CI: 0.10 to 0.68, p < 0.05). Median nerve motor and sensory velocities also improved significantly (p < 0.05). However, BSSS and BFSS did not show significant differences between groups. The within-group analysis demonstrated significant improvements in symptom severity (BSSS: MD = -10.80, 95% CI: -14.73 to -6.78, p < 0.05) and functional status (BFSS: MD = -6.44, 95% CI: -8.78 to -4.09, p < 0.05). The subgroup analysis showed that treatment benefits were sustained over time, with no significant differences between short-term and long-term follow-ups. Lymphatic drainage techniques offer a promising non-invasive approach for CTS, decreasing pain, reducing edema, and enhancing nerve conduction. While intra-group improvements were notable, limited between-group differences were observed.

Background: Childhood urinary tract infections (UTIs) are among the most prevalent diseases. In recent years, the overuse of common antibiotics has increased antibiotic resistance among urinary tract pathogens worldwide, with changes in the pattern of microbial resistance varying by geographical area and time. Objectives: This study aims to investigate the pattern of microbial resistance of UTI pathogens in pediatric patients. Methods: In this cross-sectional study, children aged < 13 years with UTI and positive urine cultures, who were admitted to Bahrami Hospital in Tehran, Iran, between 2015 and 2019, were evaluated. The pathogens' frequency, their antimicrobial resistance, and clinical and demographic information were extracted from the patients' files. Statistical relationships between clinical and demographic data and antibiotic resistance were analyzed using appropriate statistical tests. Results: The files of 202 patients were evaluated. The majority of patients were female (79.2%). UTI was more common among the 12 - 60 months age group (36.3%) in females and the 1 - 12 months age group (50%) in males. The most common UTI pathogen was Escherichia coli (85.1%). The lowest rates of microbial resistance were related to Meropenem (0% resistance), Gentamicin (9.2%), and Amikacin (10.8%). Conversely, the highest resistance rates were observed for Cotrimoxazole (74.6%), Ampicillin (74.5%), and Cephalothin (64.9%). Conclusions: UTI is more common in females aged 1 to 60 months. E. coli is the most common cause of UTI. Microbial resistance to antibiotics used for empirical treatment, such as ceftriaxone, is high and changes over time. It is recommended to use alternative antibiotics and avoid the inappropriate administration of antibiotics.