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  • Uneven Expression of 20 Human Papillomavirus Genes Associated with Oropharyngeal Carcinoma

    Background: Human papillomavirus HPV is considered to be responsible for 95% of virus-related cancers in many organs. Oropharyngeal carcinoma (OC) is distinguished by the transformation of the healthy epithelium into precancerous cells. Aim: The current study sought to examine the uneven gene expression of 20 genes among those scanned by microarray for oropharyngeal cancer patients. Materials and Methods: GSE56142 dataset was extracted from the GEO in NCBI. 24 specimens were evaluated. Gene Ontology (GO), KEGG, and the protein-protein interaction (PPI) were used to depict the biological roles of the genes under investigation using types of software. Results: Six genes out of 20 in invasive patients had a binding correlation with high expression (PDGFRS, COL6A3, COL1A1, COL3A1, COL2A1, and COL4A1), and only two genes with low expression (CRCT1 and KRT78). The expression levels of 20 genes were examined between patients with OC and head and neck squamous cell carcinoma (HNSCC). The correlation coefficient between highly expressed genes was statistically significant at the p < 0.05 level. Conclusions: It is crucial to evaluate the high expression of particular genes as diagnostic tumor markers, particularly in the early stages.
  • Action Myoclonus Secondary to Donepezil: Case Report and Literature Review

    Movement disorders associated with donepezil have been only rarely reported. Herein, we describe an older woman who developed myoclonus secondary to donepezil. A 61-year-old female presented with brief involuntary twitching. The patient reported that she consulted a general practitioner about 1 month before due to memory complaints. A diagnosis of mild cognitive impairment was made. Donepezil was started. After 4 weeks, she presented to our emergency department due to significant twitching. Multifocal myoclonus was observed. These movements occurred during rest and voluntary movement. Laboratory exams and cerebrospinal fluid analysis were normal. A cranial computed tomography and brain magnetic resonance imaging were unremarkable. Electroencephalography did not show epileptic activity. Electromyography revealed burst durations varying between 50 and 100 ms. Diazepam intravenous was started, which improved her abnormal movement within 1 hour. On the next day, she developed the same clinical symptoms of presentation. Donepezil was discontinued, and clonazepam was started. The patient had a complete recovery from her myoclonus. To the authors’ knowledge, there are six reports of myoclonus secondary to donepezil/galantamine. There is no report of rivastigmine-induced myoclonus. The most frequent presentation was multifocal myoclonus. The management was the discontinuation of the acetylcholinesterase inhibitor. All the individuals recovered within 3 weeks.
  • Cannabis and Rheumatoid Arthritis: A Scoping Review Evaluating the Benefits, Risks, and Future Research Directions

    Rheumatoid diseases, including rheumatoid arthritis, osteoarthritis, and fibromyalgia, are characterized by progressive inflammation in the musculoskeletal system, predominantly affecting the joints and leading to cartilage and bone damage. The resulting pain and ongoing degradation of the musculoskeletal system contribute to reduced physical activity, ultimately impacting quality of life and imposing a substantial socioeconomic burden. Unfortunately, current therapeutics have limited efficacy in slowing disease progression and managing pain. Thus, the development of novel and alternative therapies is imperative. Cannabinoids possess beneficial properties as potential treatments for rheumatoid diseases due to their anti-inflammatory and analgesic properties. Preclinical studies have demonstrated promising results in halting disease progression and relieving pain. However, there is a scarcity of patient clinical studies, and the available data show mixed results. Consequently, there are currently no established clinical recommendations regarding the utilization of cannabis for treating rheumatoid diseases. In this review, we aim to explore the concept of cannabis use for rheumatoid diseases, including potential adverse effects. We will provide an overview of the data obtained from preclinical and clinical trials and from retrospective studies on the efficacy and safety of cannabis in the treatment of rheumatoid diseases.
  • Surgery for Cardiac Arrhythmias: Past, Present, Future

    There is a rich history of surgery for cardiac arrhythmias, spanning from atrial fibrillation and Wolff–Parkinson–White syndrome to inappropriate sinus tachycardia and ventricular tachycardia. This review describes the history of these operations, their evolution over time, and the current state of practice. We devote considerable time to the discussion of atrial fibrillation, the most common cardiac arrhythmia addressed by surgeons. We discuss ablation of atrial fibrillation as a stand-alone operation and as a concomitant operation performed at the time of cardiac surgery. We also discuss the emergence of newer procedures to address atrial fibrillation in the past decade, such as the convergent procedure and totally thoracoscopic ablation, and their outcomes relative to historic approaches such as the Cox maze procedure.
  • Release Our Hostages Now!

    It has been the policy of Rambam Maimonides Medical Journal to limit the number of editorials published. However, silence and standing on the sidelines is not an option in light of the atrocities and inhumanity we witnessed on October 7. The savagery of the Hamas massacre was executed indiscriminately upon children, women, older people (some of whom are Holocaust survivors), infants, and even medical professionals caring for the casualties. Currently, there are about 230 women, men, children, and babies being held hostage by Hamas; among them are cancer patients and others with serious disorders, doctors, and other medical professionals. We cannot rest and must address the plight of our hostages who are being held by terrorists motivated by hatred and showing no respect for life, whether that of their enemies, their own people, or even themselves. ...
  • Myxedema Coma-Associated Pancytopenia: A Case Report

    Pancytopenia is defined as a reduction in red blood cells, white blood cells, and platelets, and can pose as a diagnostic challenge due to the multitude of causes. Myxedema coma is the manifestation of severe untreated hypothyroidism. This case report presents a rare instance of myxedema coma-associated pancytopenia in a 53-year-old man with a history of untreated hypothyroidism. The patient presented with altered mental status and vital instability, and on further workup was found to have pancytopenia. During his hospital stay his symptomatic hypothyroidism was identified, and he was treated with intravenous levothyroxine, hydrocortisone, and supportive care. The patient’s clinical status improved gradually, with normalized blood counts upon discharge. This case underscores the significance of considering myxedema coma in the differential diagnosis of pancytopenia, especially in older patients with limited healthcare access. Increased awareness of this association can aid clinicians in timely diagnosis and management, preventing potential complications associated with untreated hypothyroidism.
  • The Role of Mesenchymal Stem Cells for Corneal Endothelial Regeneration: A Systematic Review

    Objective: A single layer of tightly spaced cells, known as the endothelium, rests on the posterior side of the cornea. This endothelium regulates the stroma’s relative dehydration, which is essential for corneal clarity. Cell therapy is an innovative method being used to repair various corneal abnormalities. Mesenchymal stem cells (MSCs) are now one of the most significant types of stem cells scientists have studied. This study aimed to evaluate the role of MSCs for corneal endothelial regeneration. Methods: A systematic review was performed by searching for articles from reputable databases with many study-type references, including PubMed, Cochrane Library, Science Direct, and Google Scholar, up to January 2024. The resulting data were displayed using the 2020 PRISMA flowchart and evaluated using the PRISMA 2020 checklist. Most of the included studies were in vivo and used topical application and anterior chamber injection as the administration routes. Results: Based on the findings of this review, MSCs increased corneal endothelial cell density, improved the defect area and corneal transparency, facilitated endothelial cell regeneration and wound healing, and decreased neovascularization and corneal pro-inflammatory cytokines as compared to controls. Conclusion: Administration of MSCs into the anterior chamber could increase regeneration and proliferation of corneal endothelial tissue.
  • Imaging Manifestations of Lung Injury During the COVID-19 Outbreak: What Have We Learned?

    Coronavirus disease-19 (COVID-19) is a pandemic infectious disease caused by a novel coronavirus. Infection can result in a wide range of clinical outcomes, from an asymptomatic condition to severe bilateral pneumonia and life-threatening conditions. Diagnosis is based on the combination of a history of exposure, clinical presentation, and real-time polymerase chain reaction (RT-PCR) assays. In endemic areas, imaging tests including computed tomography (CT), chest X-ray (CXR), and ultrasound (US) have been included in the diagnostic workup. Multiple and peripheral areas of parenchymal injury is the hallmark of COVID-19 lung infection, seen as ground-glass opacification and consolidation on CT, as hazy opacities on CXR, and as multiple B-lines and subpleural consolidations on US. Of these modalities, CT has the best sensitivity and specificity, while CXR has moderate sensitivity and unknown specificity. Both CT and CXR involve ionizing radiation, increase the risk of cross-infection, and require a long sterilization time. Ultrasound is the only modality used by clinicians. Early reports have shown promising results, comparable to CT. With high availability, the lowest risk of cross-infection, and a rapid sterilization process, US may potentially become the primary imaging tool for COVID-19 pulmonary injury. Lung US training programs are needed to provide clinicians with the ability to better implement this technique.
  • Pandemic Spread—an Empirical Analysis

    The coronavirus disease-2019 (COVID-19) epidemic started in late 2019, and was upgraded to a pandemic on March 11, 2020 by the World Health Organization (WHO). Well established epidemiological models have been used over the last few months in an attempt to predict how the virus would spread. The predictions were frightening, and the resulting panic caused many governments to impose lockdowns or other severe restrictions, with lasting effects. This short paper discusses another way of looking at the spread of COVID-19, by focusing on the daily rate of infection, defined as the daily rate of increase in the number of infected persons. It is shown that the daily rate is monotonically decreasing, after a short initial period, in all countries, and that the pattern is similar in all countries. This appears to be a universal phenomenon. Based on these calculations, the April 1, 2020 data for Western Europe were sufficient to predict the beginning of the end of COVID-19 in that region before the end of that month.
  • Different Chemical Structures and Physiological/Pathological Roles of Cyclooxygenases

    This review describes cyclooxygenase (COX), which synthesizes prostanoids that play an important role in living things. The authors conducted a national and international literature review on the subject. The COX enzyme uses arachidonic acid to form prostanoids, which play a role in several physiological and pathological conditions. This enzyme has different isoforms, mainly COX-1 and COX-2. The constitutive isoform is COX-1, while COX-2 is the inducible isoform. Both are expressed in different tissues and at different levels, but they may also coexist within the same tissue. Both isoforms show essentially the same mode of action, but their substrates and inhibitors may differ. The COX-1 isoform, which plays a role in the continuation of physiological events, has an increased expression level in various carcinomas, and the COX-2 isoform, which is increased in inflammatory conditions, is typically expressed at low physiological levels in some tissues such as the brain, kidney, and uterus. In addition to investigating the efficacies of the COX-1 and COX-2 isoforms, the discovery of potential new COX enzymes and their effect continues. This review also looks at the roles of the COX enzyme in certain physiological and pathological conditions.