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Background Multiple sclerosis (MS) can result in significant mental and physical symptoms, specially muscle weakness, abnormal walking mechanics, balance problems, spasticity, fatigue, cognitive impairment and depression. Patients with MS frequently decrease physical activity due to the fear from worsening the symptoms and this can result in reconditioning. Physicians now believe that regular exercise training is a potential solution for limiting the reconditioning process and achieving an optimal level of patient activities, functions and many physical and mental symptoms without any concern about triggering the onset or exacerbation of disease symptoms or relapse. Main body Appropriate exercise can cause noteworthy and important improvements in different areas of cardio respiratory fitness (Aerobic fitness), muscle strength, flexibility, balance, fatigue, cognition, quality of life and respiratory function in MS patients. Aerobic exercise training with low to moderate intensity can result in the improvement of aerobic fitness and reduction of fatigue in MS patients affected by mild or moderate disability. MS patients can positively adapt to resistance training which may result in improved fatigue and ambulation. Flexibility exercises such as stretching the muscles may diminish spasticity and prevent future painful contractions. Balance exercises have beneficial effects on fall rates and better balance. Some general guidelines exist for exercise recommendation in the MS population. The individualized exercise program should be designed to address a patient’s chief complaint, improve strength, endurance, balance, coordination, fatigue and so on. An exercise staircase model has been proposed for exercise prescription and progression for a broad spectrum of MS patients. Conclusion Exercise should be considered as a safe and effective means of rehabilitation in MS patients. Existing evidence shows that a supervised and individualized exercise program may improve fitness, functional capacity and quality of life as well as modifiable impairments in MS patients.

Many renal cancer patients experience disease recurrence after combined treatments or immunotherapy due to permanence of cancer stem cells (CSCs). This study was conducted to evaluate the expression patterns and clinical significance of octamer-binding transcription factor 4 (OCT4) and NANOG as the key stem cell factors in renal cell carcinoma (RCC). A total of 186 RCC tissues were immunostained on a tissue microarray (TMA) for the putative CSC markers OCT4 and NANOG. Subsequently, the correlation among the expression of these markers, the clinicopathological variables and survival outcomes were determined. OCT4 and NANOG were expressed in both the nucleus and the cytoplasm of RCC cells. Coexpression of OCT4 and NANOG in renal cancer was significantly associated with RCC subtypes. A significant association was found among nuclear coexpression of OCT4 and NANOG, worse PFS in RCC, and the clear cell renal cell carcinomas (ccRCC) subtype. The OCT4-nuclear high /NANOG-nuclear high phenotype in RCC and ccRCC subtype indicated aggressive tumor behavior and predicted a worse clinical outcome, which may be a useful biomarker to identify patients at high risk of postoperative recurrence and metastasis. Cytoplasmic expression of NANOG could be considered as a novel independent prognostic predictor in patients with renal cancer.

Melanoma antigen gene (MAGE)-A6 and MAGE-A11 are two of the most cancer-testis antigens overexpressed in various types of cancers. However, the clinical and prognosis value of MAGE-A6 and MAGE-A11 co-expression in the pathophysiology of the bladder is unknown. Three studies were selected from GEO databases in order to introduce the common genes that are involved in bladder cancer. Then immunohistochemical analysis for staining pattern and clinicopathological significance of suggested markers, MAGE-A6 and MAGE-A11, were performed in 199 and 213 paraffin-embedded bladder cancer with long adjacent normal tissues, respectively. A significant and positive correlation was found between both nuclear and cytoplasmic expressions of MAGE-A6 as well as expression of cytoplasmic MAGE-A11 with histological grade, PT stage, lamina propria invasion, and LP/ muscularis (L/M) involvement (all of the p-values in terms of H-score were < 0.0001). Additionally, significant differences were found between both nuclear and cytoplasmic MAGE-A6/MAGE-A11 phenotypes with tumor size (P = 0.007, P = 0.043, respectively), different histological grades, PT stage, LP involvement, and L/M involvement (all of the p-values for both phenotypes were < 0.0001). The current study added the value of these novel markers to the bladder cancer clinical settlement that might be considered as an admirable target for immunotherapy.

Background The crucial oncogenic role of cancer stem cells (CSCs) in tumor maintenance, progression, drug resistance, and relapse has been clarified in different cancers, particularly in colorectal cancer (CRC). The current study was conducted to evaluate the co-expression pattern and clinical significance of epithelial cell adhesion molecules (EpCAM) and activated leukocyte cell adhesion (CD166 or ALCAM) in CRC patients. Methods This study was carried out on 458 paraffin-embedded CRC specimens by immunohistochemistry on tissue microarray (TMA) slides. Results Elevated expression of EpCAM and CD166 was observed in 61.5% (246/427) and 40.5% (164/405) of CRC cases. Our analysis showed a significant positive association of EpCAM expression with tumor size ( P = 0.02), tumor stage ( P = 0.007), tumor differentiate ( P = 0.005), vascular ( P = 0.01), neural ( P = 0.01), and lymph node ( P = 0.001) invasion. There were no significant differences between CD166 expression and clinicopathological parameters. Moreover, the combined analysis demonstrated a reciprocal significant correlation between EpCAM and CD166 expression ( P = 0.02). Interestingly, there was a significant positive correlation between EpCAM/CD166 phenotypes expression and tumor stage ( P = 0.03), tumor differentiation ( P = 0.05), neural, and lymph node invasion ( P =0.01). Conclusions The significant correlation of EpCAM and CD166 expression and their association with tumor progression and aggressive behavior is the reason for the suggestion of these two CSC markers as promising targets to promote novel effective targeted-therapy strategies for cancer treatment in the present study.

PurposeFood addiction (FA) following bariatric surgery (BS) has received a burst of attention in recent years due to its important contribution to obesity. Therefore, this study was conducted to explore the prevalence of FA disorder and its predictors 2 years after laparoscopic sleeve gastrectomy (LSG) and assess its relationship with physical activity (PA), body composition, and weight outcomes.Materials and MethodsFour hundred fifty individuals who had undergone LSG 2 years prior to the study were enrolled. FA was diagnosed using the Yale Food Addiction Scale (YFAS). The collected data included body composition (fat mass (FM), fat-free mass (FFM)), PA, and nutritional intakes.ResultsEighty-nine subjects (about 20%) met the criteria for FA disorder. FA patients had significantly lower PA (p = 0.04) and higher weight (p < 0.001), BMI (p < 0.001), FM, and FFM (p = 0.01) compared to those without FA. Regarding weight and body composition changes, the finding reveals that FA patients (vs. non-FA) had a significantly less excess weight loss (EWL%) (p < 0.001) and total weight loss (TWL%) (p = 0.05) as well as a higher FFM loss (kg) (p = 0.04) (linear regression analysis). A younger age (p trend = 0.01), higher BMI (p trend = 0.04), and more excess weight (p trend = 0.03) were related to higher odds of FA disorder at second year after LSG (logistic regression analysis).ConclusionThe results showed that FA was highly prevalent 2 years after LSG. In addition, FA disorder was associated with negative long-term outcomes following LSG. Younger individuals with more excess weight and higher BMI at baseline are more vulnerable to FA.

Background The assessment of the postural condition with functional tests are used with the least facilities in the shortest time, for a wide the range of movements for different parts of the body. Both static and dynamic posture measurements are predictive of injury. These two assessments provide different information regarding posture control. Also, with the advancement of this technology, the speed of posture assessment and deformity diagnosis can be increased and done with the minimum facilities. This can signal a new method for the quick diagnosis of abnormalities and ultimately prevent or correct psychological effects and musculoskeletal pain in the future. Because as seen according to the citations, abnormalities cause musculoskeletal pains, movement restrictions and ultimately affect the quality of life. Methods The current research is of the applied and semi-experimental type, and in terms of the results it is of the relational and correlational type. In this research, 148 non-Athletic women from Fardis City participated, in which the results obtained from the static evaluation was analyzed by the Posture Screen application after taking photos from four directions using a smartphone, and also the dynamic evaluation was identified and analyzed by the researcher using the overhead squat test of compensatory movements, with the data that from Cornell pain and quality of life SF-36 questionnaires was. Data description and correlation between variables were done with the η coefficient method. Results According to the findings there is a positive and significant correlation between the prevalence of uneven pelvic deformity and the amount of pain in non-athletic women ( P  = 0.036, η (148)  = 0.17). In other words, pain increased significantly when the pelvis was changed from a normal position to a lateral deviation position. Also, there is a negative and significant relationship between the prevalence of deformity of knee movement, back arch, straight back, heel lift and the quality of life in non-athletic women ( P  = 0.020, η (148)  = 0.19). Conclusions According to the results, deformities have an effect on pain and the frequency of pain, on the other hand, in the present study, dynamic evaluations showed deformities more accurately than static evaluations.

Background Gastric cancer (GC) poses significant challenges globally, ranking fifth in incidence and fourth in cancer-related mortality. SALL4, a stem cell transcription factor with multiple isoforms, includes SALL4-A as its full-length form. This study aims to evaluate the diagnostic potential of SALL4-A isoform expression in GC and its clinical significance. Method Immunohistochemical (IHC) analysis was conducted on Tissue Micro Array (TMA) slides from 167 GC patients. Clinicopathological parameters were correlated with SALL4-A expression, and survival analysis was performed. Diagnostic performance was assessed using metrics such as sensitivity, specificity, and area under the curve (AUC). Results SALL4-A exhibited distinct cytoplasmic expression in GC, correlating with lower histological grade ( p  = 0.003) and TNM stage ( p  = 0.003), particularly in the intestinal subtype. Diagnostic evaluation showed an AUC of 0.803 for cytoplasmic expression, demonstrating high diagnostic potential. However, SALL4-A expression did not show significant prognostic value. Conclusion Cytoplasmic SALL4-A expression in GC is associated with less aggressive tumor phenotypes and shows promise as a diagnostic marker. Further research is warranted to elucidate its mechanistic role and potential integration into clinical practice.

PurposeOne-anastomosis gastric bypass (OAGB) is a novel laparoscopic approach. The anastomosis of OAGB can be sewn either with a stapler or manually. The aim of this study is to determine the outcome of hand-sewn OAGB.Materials and MethodsA total of 805 consecutive patients were retrospectively enrolled in this study. Data collection included change in weight, body mass index (BMI), symptoms, and complications before surgery and continued during annual follow-up visits up to 5 years. Inclusion criteria were patients with a BMI of higher than 40 kg/m2 or higher than 35 kg/m2 with one severe comorbidity. Patients with BMI > 50 kg/m2 were referred to dieticians.ResultsThe follow-up rate ranged from 93 to 50% at the 1-year and 5-year visits after surgery, respectively. Mean weight and BMI of patients before surgery were 121.93 kg (± 22.92) and 44.79 kg/m2 (± 6.07), respectively. Mean of annual BMI in 5 years of follow-up were 27.83, 27.26, 28.90, 29.45, and 29.56 kg/m2. Excess weight loss (EWL) in 5 years of follow-up were 85.7%, 89.5%, 78.9%, 77.7%, and 76.0%. Reflux was present in 202 patients (25.1%) before surgery and resolved in 153 cases (75.7%) 1 year after surgery. Procedure-specific early complication was an anastomosis leak in one patient, which led to death. Two cases of malnutrition necessitating reversal and two severe reflux disorders leading to Roux-en-Y bypass surgery were remarkable late complications.ConclusionHand-sewn anastomosis could represent an efficient and safe technique in the management of patients undergoing OAGB surgery with acceptable outcomes and rare adverse complications.