Birjand University of Medical Sciences

Pancreatic cancer is a highly lethal malignancy, ranking tenth in incidence among all cancers and standing as the fourth leading cause of cancer-related mortality worldwide. This systematic review and meta-analysis evaluated the diagnostic performance of exosomal biomarkers for detecting pancreatic ductal adenocarcinoma (PDAC). A total of 1,666 records were identified through comprehensive searches in Scopus, Web of Science, and PubMed. After removing duplicates and screening titles, abstracts, and full texts, 15 studies comprising 1,961 individuals (971 PDAC patients and 990 controls) were included. The quality of studies was assessed using the QUADAS-2 tool, revealing potential biases mainly in patient selection and index test domains. Three biomarker categories were analyzed: exosomal microRNAs (exomiRs), cancer antigen 19-9 (CA 19-9), and glypican-1 (GPC1). ExomiRs demonstrated the highest pooled sensitivity (0.86; 95 % CI: 0.80-0.90) and lowest negative likelihood ratio (0.16; 95 % CI: 0.11-0.24), while CA 19-9 showed the highest specificity (0.91; 95 % CI: 0.84-0.95) and positive likelihood ratio (8.5; 95 % CI: 4.4-16.4). ExomiRs also had the highest diagnostic odds ratio (DOR = 35.4; 95 % CI: 18.7-67.0) and area under the SROC curve (AUC = 0.92; 95 % CI: 0.89-0.94), indicating superior diagnostic performance compared to CA 19-9 and GPC1 (AUC = 0.88 and 0.78, respectively). GPC1 consistently showed lower diagnostic metrics across all analyses. Deeks' funnel plot suggested no publication bias for CA 19-9 and GPC1, but indicated potential bias for exomiRs (P = 0.01). Overall, exomiRs appear to be promising non-invasive biomarkers for the early detection of PDAC, outperforming traditional and other exosome-based markers in diagnostic accuracy.

Blastocystis is a prevalent intestinal parasitic protist that infects both birds and animals. There are at least 44 subtypes (ST) of Blastocystis, with ST1-ST9 being found in humans. The correlation between specific subtypes and pathogenicity has not been definitively established. This study aimed to identify the genetic diversity within subtypes of Blastocystis in stool samples collected from individuals who were referred to medical facilities in the cities of Birjand, Darmian, Nehbandan and Ferdows, Eastern Iran.

A total of 1800 stool specimens were randomly collected from referred individuals in selected medical laboratories of South Khorasan province. DNA was extracted and PCR before, sequencing and subtyping were performed for characterization and phylogenetic analysis.

A total of 118 (6.5%) individuals were examined positive with Blastocystis through microscopic observations. A ~ 620-bp segment of the SSU rRNA gene of Blastocystis was amplified and were genetically evaluated using MEGA6 and DnaSP. 30 samples of Blastocystis positive samples were sequenced. BLAST analyses identified 3 distinct subtypes including ST1 (11, 36.66%), ST2 (5, 16.68%), ST3 (14, 46.66) within our samples. Intra-subtype discrimination showed the similarity of 95.88%, 91.56% and 92.14% for ST1 and ST2, ST1 and ST3, and ST2 and ST3, respectively. Additionally, allele 4 for ST1; allele 12 for ST2; and alleles 34 and 36 for ST3 were detected.

As results, ST1 exhibited the highest nucleotide diversity (π: 0.00113), suggesting a high degree of genetic diversity within this subtype. Phylogenetic analysis showed that, ST3 was clustered to animal isolates from cattle and cats, indicating the potential zoonotic transmission of Blastocystis.

Myocardial infarction (MI) is a leading global cause of mortality, necessitating novel biomarkers for early diagnosis and prognosis. This review explores circulating cell-free DNA (cfDNA) as a minimally invasive tool for MI detection, focusing on its mechanistic role, diagnostic accuracy, and potential in personalized medicine. CfDNA levels rise rapidly post-ischemic event, correlating with myocardial damage and complementing troponins. Liquid biopsies using cfDNA enable dynamic monitoring of disease progression, but methodological variability and low concentrations limit its standalone use. Standardizing protocols and integrating cfDNA into multi-marker panels could enhance its clinical utility, positioning it as a transformative cardiovascular diagnostic tool.