Hassan Foroozand

Background: Uveal melanoma (UM) is the prevailing malignant tumor that develops within the eye in adults, and it has a bleak outlook because of the few treatment choices available and the high likelihood of returning after treatment. Currently, surgical intervention, radiation therapy, and a combination of both modalities are available therapeutic modalities for controlling UM. However, these techniques are associated with notable adverse effects and have limited efficacy. Therefore, there is a lack of sufficient and reliable therapies for UM, especially for advanced and metastatic UM forms. This review aims to summarize the clinical features and current therapies of UM and highlight recent progress in gene therapy approaches. Recent Findings: Significant developments in gene therapy have introduced multiple strategies for targeting UM. Gene silencing using siRNA and shRNA has shown efficacy in downregulating oncogenic pathways. CRISPR/Cas9‐based editing has enabled selective disruption of tumor‐promoting genes, sensitizing tumor cells to targeted inhibitors. Restoration of tumor‐suppressive miRNAs has reduced proliferation, migration, and invasion of UM cells in preclinical models. Suicide gene therapy has demonstrated potent cytotoxicity in xenografts. Moreover, oncolytic viruses and stem‐cell–associated delivery systems provide novel mechanisms for tumor‐selective gene expression and immune activation. Although challenges persist—such as delivery efficiency, immune responses, and genetic heterogeneity—ongoing innovations in vector design, non‐viral nanoformulations, and mutation‐guided therapies continue to enhance clinical feasibility. Conclusion: Gene therapy provides improved safety profiles and the possibility of tailored treatment strategies by integrating information on gene expression patterns and DNA alterations. In the future, gene therapy has the potential to improve the treatment of UM by targeting specific genetic mutations driving tumor growth and may offer new hope for patients with advanced stages of UM.

Background: There is a lack of conclusive evidence regarding thyroid function test (TFT) abnormalities in COVID-19, especially among children. Objectives: This study aimed to investigate TFT abnormalities in COVID-19 pediatric patients compared to healthy children. Methods: This study was conducted on 37 COVID-19-positive children who were admitted to Namazi Hospital from January 21 to March 1, 2022, compared with 37 healthy children. Within 48 h of positive real-time polymerase chain reaction (PCR) results for severe acute respiratory syndrome coronavirus 2, a blood sample was taken to measure serum levels of thyroid-stimulating hormone (TSH) and total thyroxine (tT4) in the two groups. Additional tests, including free and total triiodothyronine, free T4, and thyroperoxidase antibodies, were also conducted on cases. The chi-square, Pearson correlation coefficient, and analysis of variance tests were used for data analysis. Results: Twenty-five patients were male, and 49 were female, with a mean age of 7.99 ± 5.02. The abnormal TFT and TSH frequency was significantly higher in the case group than in the control group. Nevertheless, there was no significant difference between the case and control groups regarding tT4 abnormalities. We could not establish an association between the mean of TSH and tT4 and age groups in the two groups and between abnormalities of TFTs and COVID-19 severity. Conclusions: Although abnormalities of TFT were significantly more common among COVID-19 children, they were not associated with the disease severity. However, studies with larger sample sizes are recommended to evaluate thyroid abnormalities and their clinical course in COVID-19 children.

Objectives: This systematic review and meta-analysis aimed to compare coronavirus disease 2019 (COVID-19) (Wuhan strain) features in children and adults during the initial pandemic phase. Methods: Until June 4, 2020, a systematic search was conducted on the EMBASE, PubMed, Web of Science, Google Scholar, and Scopus to find and collect studies based on available data among adults and children. The heterogeneity of the studies was assessed using I2 statistics and chi-square testing. The random-effect model was used to pool the effect sizes due to inter-study heterogeneity (chi-square P-value 0.1 and I2 >50%). Results: Fever (65.73%), cough (53.78%), expectoration (37.9%), gastrointestinal symptoms (37.01%), headache (23.41%), shortness of breath (21.65%), and myalgia (20.79%) were the most common symptoms reported in children, according to the pooled estimation analysis. Arthralgia (Effect estimate (ES): adults = 2.15, children = 17.94) and headache (ES: adults = 9.22, children = 23.41) were significantly observed higher in children (P-value = 0.019). Adult patients had a higher rate of abnormal computed tomography (CT)-scan findings, while most children had a normal imaging studies. Adults had significantly higher rates of comorbidities, whereas children had significantly higher rates of asthma (ES: 17.94% vs 8.85%; P-value = 0.026) and malignancy (ES: 10.36% vs 5.47%; P-value = 0.045). During initial pandemic phase, hydroxychloroquine (ES: 66.21% vs 29.01%; P-value = 0.001) and antibiotics (ES: 77.86% vs 38.01%; P-value = 0.001) were used much more frequently in adult patients. Adults used much more antibiotics than children. Nonetheless, antibiotics were given to around 40% of the children studied. Conclusions: Although children were afflicted less than adults in the early stages of the pandemic and had lower mortality, clinical and radiological findings, as well as prognostic factors, did not differ significantly between adults and children. However, with the advent of novel variants, clinical signs and symptoms, complications, and outcomes changed in children significantly.