Falling and rising in the vortex of cancer: children's adaptation with cancer: a qualitative study.

BACKGROUND: Cancer is a considerable health problem worldwide and the second leading cause of death in children. It has many physical, psychological, and social consequences for children and their families. The ability to adapt to cancer plays a vital role in the recovery and quality of life of affected children. This study aimed to explain the adaptation of children with cancer to their disease. METHODS: This qualitative study adopted the directed content analysis approach based on the Roy nursing model. The participants were nine children with cancer aged 6-18 years old, five family members, four nurses, one doctor, one teacher, and two charity association members, recruited by purposive sampling method. The information was collected via individual semi-structured interviews, a focus group discussion, and field notes. The data were analyzed simultaneously with data collection using the Elo and Kyngäs method. The study rigor was ensured based on the Guba and Lincoln criteria. FINDINGS: Of the four categories of physical challenges, fragile self-concept, the difficulty of role transition, and disruption of the path to independence, the theme of Falling and rising in the cancer vortex was abstracted. CONCLUSION: Based on the Roy model, the children in the present study were at the compensatory level of adaptation. This research demonstrates that the adaptation of children being treated for cancer is fragile and not constant. With each hospitalization and exacerbation of the disease, they made efforts to adapt to their disease using regulatory and cognitive subsystems. Paying attention to different stimulants and the effects of support systems on physical challenges, fragile self-concept, difficult role transition, and disruption of the path to independence for each child, as well as providing individualized care for these children, can help their adaptation to and healthy transition from the vortex of cancer. The Roy adaptation model was helpful and efficient for elucidating the adaptation of children with cancer. Providing care for children by healthcare specialists, especially nurses, should be theory-based and individualized.

Evaluation of quality of life and associated factors in patients with intertrochanteric femoral fracture.

BACKGROUND: Intertrochanteric fracture is a common injury among the elderly, causing fundamental lifestyle derangements, influencing the patients' social and psychological functioning. We aimed to study the quality of life (QoL) and its different parameters in patients with this type of injury. MATERIALS AND METHODS: In this cross-sectional study, all patients hospitalized with intertrochanteric fracture aged above 50 from 2020 to 2022 at the Shahid Beheshti Hospital in Babol, Iran, were included. Patients were primarily managed surgically and, in exceptional cases non-surgically, were followed up for at least 12 months after receiving treatment. During the follow-up period, patients were dialled and completed a questionnaire to assess the patient's QoL by the 36-item Short Form Health Survey (SF-36). QoL parameters were analyzed based on patients' sex, age, type of treatment, and height of fall causing fracture. RESULT: A total number of 200 patients, including 101 (50.5%) males and 99 (49.5%) females, with a mean age of 74.76±11.36 years (range: 50-99), were included. Regarding the received treatment, 192 (96.0%) patients underwent surgery, and 8 (4.0%) underwent non-surgical treatment. In the study of SF-36 scores, the mean score of male patients was 42.31±14.58, and females scored 37.83±15.35, and the difference was statistically significant (P = 0.04). The mean score of QoL and its subscales among the 50-75 group patients was significantly higher than the 76-99 group (P<0.001). The average score of QoL was considerably higher in patients who had surgery (40.75±14.57) compared to those who had non-surgical treatment (24.30±19.85) (P = 0.01). Patients having a fall from a higher height had higher QoL after treatment. CONCLUSION: This study revealed that patients with an intertrochanteric femoral fracture had poor QoL in all aspects. The overall QoL was significantly higher among male patients, younger patients, those who underwent surgical treatment, and the falls from higher heights. These findings highlight the necessity of long-term follow-up and support in patients with intertrochanteric fractures.

Different Modification Methods of Poly Methyl Methacrylate (PMMA) Bone Cement for Orthopedic Surgery Applications.

In clinical practice, bone defects that occur alongside tumors, infections, or other bone diseases present significant challenges in the orthopedic field. Although autologous and allogeneic grafts are introduced as common traditional remedies in this field, their applications have a series of limitations. Various approaches have been attempted to treat large and irregularly shaped bone defects; however, their success has been less than optimal due to a range of issues related to material and design. However, in recent years, additive manufacturing has emerged as a promising solution to the challenge of creating implants that can be perfectly tailored to fit individual defects during surgical procedures. By fabrication of constructs with specific designs using this technique, surgeons are able to achieve much better outcomes for patients. Polymers, ceramics, and metals have been used as biomaterials in Orthopedic Surgery fields. Polymeric scaffolds have been used successfully in total joint replacements, soft tissue reconstruction, joint fusion, and as fracture fixation devices. The use of polymeric biomaterials, either in the form of pre-made solid scaffolds or injectable pastes that can harden in situ, shows great promise as a substitute for commonly used autografts and allografts. Polymethyl methacrylate (PMMA) is one of the most widely used polymer cement in orthopedic surgery. The present paper begins with an introduction and will then provide an overview of the properties, advantages/disadvantages, applications, and modifications of PMMA bone cement.

Role of biomarkers in the diagnosis of invasive aspergillosis in immunocompromised patients.

BACKGROUND: Invasive aspergillosis is one of the important causes of infection in immunocompromised patients. This study aimed to evaluate the roles of biomarkers in the diagnosis of invasive aspergillosis and their relationship with antifungal stewardship programs. METHODS: 190 sera from 52 immunocompromised patients and volunteer individuals were included in this study. 18 immunocompromised volunteers without IA and 34 patients with probable and proven aspergillosis according to the European Organization for Research and Treatment of Cancer and the Mycoses Study Group consensus definitions were entered in this study. The respective sera were evaluated for procalcitonin, soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) levels; white blood cells count (WBC) count, C reactive protein (CRP), lactate dehydrogenase (LDH), and erythrocyte sedimentation rate (ESR) values. Demographic data and clinical characteristics of patients were extracted from their files. RESULTS: The male-to-female ratio and mean age of patients were 22/12 and 38.9 years, respectively. The hematologic disorder was the most predisposing factor (29/34, 85.3%). Sensitivity of biomarkers for diagnosis of invasive aspergillosis was 70.6% (cut off value > 190 pg/mL for sTREM-1, 71% (cut off value > 260 pg/mL) for PCT, 85.3% (cut off value > 193 U/L) for LDH, 94.1% (cut off value > 8 mg/l) for CRP, 64.7% (cut off value < 5200 cells/ml) for WBC, and 85.3% (cut off value > 23 mm/h) for ESR. Twelve patients died, with significantly increased sTREM-1 levels and decreased WBC count in them. CONCLUSION: According to our data, evaluation of the biomarkers can help in the diagnosis, management, and prediction of the severity of Aspergillus infection, and the rational use of antifungal agents in immunocompromised patients.

Significance of biomarkers in stewardship program in pediatric patients infected with Aspergillus species.

BACKGROUND: The potential use of biomarkers in the diagnosis of fungal infections is a challenge. The aim of this study was to evaluate the role of a biomarker-guided antifungal stewardship program for hospitalized pediatrics suffering from invasive aspergillosis (IA). METHODS: Pediatric patients with suspected probable or proven IA were enrolled in this study. Demographic data were collected from their records. Clinical samples were examined by wet mount KOH smear, culture, galactomannan Ag test, and real-time PCR. Patients' sera were evaluated for procalcitonin (PCT) and soluble-triggering receptor expressed on myeloid cells -1 (sTREM-1) levels by ELISA Kits. RESULTS: A total of 73 children were entered in this study with a mean age of 5 years and the male to female ratio 39/34. The most predisposing factors were hematologic disorders (71.2%). The area under the curves (95% confidence interval) for each biomarker were 0.9 (0.85% to 97%) for lactate de hydrogenase (LDH), 0.9 (0.85% to 0.94%) for C-reactive protein, 0.8 (0.75% to 0.84%) for PCT, 0.8 (0.73% to 0.85%) for erythrocyte sedimentation rate, 0.7 (0.6% to 0.8%) for sTREM-1, and 0.5 (0.45% to 0.58%) for white blood cell count. During the study period, 27.4% patients died. The LDH and sTREM-1 levels were significant increase in died patient (p < 0.05). CONCLUSIONS: According to our data, evaluation of biomarkers along with radiologic and clinical signs and symptoms of pediatric patients can lead to proper antifungal therapy and decreased side effects, antifungal resistance, and cost. The combined measurements could be better than a single marker in the prediction of IA.

A study on women's health information needs in menopausal age.

Menopause is a natural event experienced by women in middle age. To help women manage this event, it is important to identify their health information needs. A study specific questionnaire was used to identify menopausal women's health information needs and the resources and challenges related to finding information about menopause. A total of 301 women aged 48-55 years completed the questionnaire. Data were analysed using negative binomial regression and chi-square tests. The most frequently sought information was that related to breast cancer (n = 209, 69.5%), hot flushes (n = 200, 66.5%), cervical cancer (n = 194, 64.5%), non-hormonal therapies for menopausal symptoms (n = 192, 64%), laboratory tests (n = 189, 63%) and joint and muscle pain (n = 188, 62.5%). The main sources of information were audiovisual media (n = 171, 57%), obstetricians (n = 165, 55%), friends (n = 157, 52%), family (n = 157, 52%) and the internet (n = 153, 51%). The two main challenges were not knowing how to correctly access information (n = 115, 38%) and not being aware of reliable sources of information (n = 108, 36%). Therefore, it is essential for policymakers and decision-makers to provide reliable and accurate information to increase awareness and reduce anxiety of women experiencing menopause.

Impact of antifungal stewardship interventions on the susceptibility of colonized Candida species in pediatric patients with malignancy.

There is a worldwide concern regarding the antimicrobial resistance and the inappropriate use of antifungal agents, which had led to an ever-increasing antifungal resistance. This study aimed to identify the antifungal susceptibility of colonized Candida species isolated from pediatric patients with cancer and evaluate the clinical impact of antifungal stewardship (AFS) interventions on the antifungal susceptibility of colonized Candida species. Candida species colonization was evaluated among hospitalized children with cancer in a tertiary teaching hospital, Shiraz 2017-2018. Samples were collected from the mouth, nose, urine, and stool of the patients admitted to our center and cultured on sabouraud dextrose agar. The isolated yeasts identified by polymerase chain reaction-restriction fragment length polymorphisms (PCR-RFLP). DNA Extracted and PCR amplification was performed using the ITS1 and ITS4 primer pairs and Msp I enzyme. The broth microdilution method was used to determine the minimum inhibitory concentrations (MICs) for amphotericin B, caspofungin, and azoles. The prevalence of Candida albicans in the present study was significantly higher than other Candida species. Candida albicans species were completely susceptible to the azoles. The susceptibility rate of C. albicans to amphotericin B and caspofungin was 93.1% and 97.1%, respectively. The fluconazole MIC values of Candida albicans decreased significantly during the post-AFS period (P < 0.001; mean difference: 72.3; 95% CI of the difference: 47.36-98.62). We found that 52.5% (53/117) of the isolated C. albicans were azole-resistant before AFS implementation, while only 1.5% (2/102) of the isolates were resistant after implementation of the AFS program (P < 0.001). C. albicans fluconazole and caspofungin resistant rate also decreased significantly (P < 0.001) after implementation of the AFS program [26 (32.9%) versus 0 (0.0%) and 11 (10.9%) versus 1 (0.9%), respectively]. Besides, fluconazole use (p < 0.05) and fluconazole expenditure reduced significantly (about one thousand US$ per year) after the AFS program. Our results confirm the positive effect of optimized antifungal usage and bedside intervention on the susceptibility of Candida species after the implementation of the AFS program. C. albicans and C. glabrata exhibited a significant increase in susceptibility after the execution of the AFS program.

Redox imbalance in Crohn's disease patients is modulated by Azathioprine.

BACKGROUND: Crohn's disease (CD) is a chronic inflammatory disease without a specific cause. Inflammation in these patients can disturb the oxidants/antioxidants balance and results in oxidative stress that plays a destructive role. This study aimed to evaluate the gene expression of sod1, sod2, cat, nrf2 and gp91phox in CD patients before and after Azathioprine (Aza) consumption. METHOD: Peripheral bloodmononuclear cells (PBMCs) were separated from CD patients (n= 15, mean age = 33.6 ± 1.8) before and after treatment with Aza and healthy controls (n= 15, mean age = 31.5 ± 1.2). The expression levels of sod1, sod2, cat, nrf2 and gp91phox were measured in byusing real-time qRT-PCR technique. RESULT: The expression levels of gp91phox (P-value < 0.001), cat (P-value < 0.05), sod1 (P-value < 0.001), nrf2 (P-value < 0.001) were significantly increased compared to control group. Following treatment with Aza, the decreased expression levels of gp91phox (P-value < 0.05), cat (P-value < 0.05), sod1(P-value < 0.001) and nrf2 (P-value < 0.001) were observed in CD patients. CONCLUSION: Overall, our results showed that prescription of Azathioprine can lead to the altered expression of redox system-related genes in patients with CD.

Suspended fine particulate matter (PM2.5), microplastics (MPs), and polycyclic aromatic hydrocarbons (PAHs) in air: Their possible relationships and health implications.

Exposure to fine particulate matter (PM2.5) and their associated microcontaminants have been linked to increased harmful effects on the human health. In this study, the possible relationships between PM2.5, microplastics (MPs), and polycyclic aromatic hydrocarbons (PAHs) were analyzed in an urban area of Bushehr port, in the northern part of the Persian Gulf. Presence, sources, and health risks of MPs and PAHs in both normal and dusty days were also investigated. The median of PM2.5 and Æ©PAHs were 52.8 µg/m3 and 14.1 ng/m3, respectively, indicating high pollution levels especially in dusty days. The mean level of MPs in urban suspended PM2.5 was 5.2 items/m3. Fragments were the most abundant shape of identified MPs and polyethylene terephthalate (PET) was the most plastic types in urban dust of Bushehr port. The results revealed that PM2.5 and MPs may possibly act as a carrier for airborne MPs and PAHs, respectively. In addition, the significant positive relationships between MPs, wind speed and wind direction, confirmed that the MPs transportation were highly controlled by atmospheric condition. Moreover, the source identification methods and trajectory analyses indicated that petrogenic sources from both proximal and distal origins play an important role in the level of PAHs. The results of chronic health risk evaluation via inhalation revealed that PM2.5-bound PAHs had high potential cancer risk in winter, while, the estimated risks for non-carcinogenic PAHs were not considerable. In the case of MPs, the assessment of human intake of MPs via inhalation highlighted the possible risks for habitants.

Atorvastatin Sensitizes Breast and Lung Cancer Cells to Ionizing Radiation.

Tumour cells may be resistant to radiotherapy that results in unsuccessful cancer treatment in patients. The aim of this study was to evaluate the sensitizing effect of atorvastatin (ATV) on breast cancer (MDA-MB-231) and non-small cell lung cancer (A-549) cells following exposure to ionizing radiation (IR). These cells were treated with ATV and exposed to X-ray at dose 4 Gy. The radiosensitizing effects of ATV were evaluated by flow cytometry and anti-proliferation assays. The production of reactive oxygen species (ROS) was determined in irradiated and treated cells with ATV. The findings of this study showed that ATV increased the percentage of apoptotic cells in irradiated breast and lung cancer cells. ATV exhibited anti-proliferative effect on cancer cells and increased cell death induced by IR. ATV increased ROS production in irradiated cells. The present study demonstrates that ATV has radiosensitizing effect on breast and lung cancer cells through increasing apoptosis, ROS production and cell death induced by IR.

Cerebral and pulmonary aspergillosis, treatment and diagnostic challenges of mixed breakthrough invasive fungal infections: case report study.

BACKGROUND: Breakthrough invasive fungal infections (bIFIs) are an area of concern in the scarcity of new antifungals. The mixed form of bIFIs is a rare phenomenon but could be potentially a troublesome challenge when caused by azole-resistant strains or non-Aspergillus fumigatus. To raise awareness and emphasize diagnostic challenges, we present a case of mixed bIFIs in a child with acute lymphoblastic leukemia. CASE PRESENTATION: A newly diagnosed 18-month-old boy with acute lymphoblastic leukemia was complicated with prolonged severe neutropenia after induction chemotherapy. He experienced repeated episodes of fever due to extended-spectrum beta-lactamase-producing Escherichia coli bloodstream infection and pulmonary invasive fungal infection with Aspergillus fumigatus (early-type bIFIs) while receiving antifungal prophylaxis. Shortly after pulmonary involvement, his condition aggravated by abnormal focal movement, loss of consciousness and seizure. Cerebral aspergillosis with Aspergillus niger diagnosed after brain tissue biopsy. The patient finally died despite 108-day antifungal therapy. CONCLUSIONS: Mixed bIFIs is a rare condition with high morbidity and mortality in the patients receiving immunosuppressants for hematological malignancies. This case highlights the clinical importance of Aspergillus identification at the species level in invasive fungal infections with multiple site involvement in the patients on antifungal prophylaxis.

Levels and ecological and health risk assessment of PM2.5-bound heavy metals in the northern part of the Persian Gulf.

Bushehr, a port along the northern part of the Persian Gulf, has repeatedly encountered dust storms in recent years but there is not been a comprehensive study on the PM2.5 contents in this region. The present study reports the characteristics and health risks of atmospheric PM2.5-bound heavy metals (HMs) in Bushehr from December 2016 to September 2017. A total of 46 samples were analyzed, and a high volume air sampler equipped with quartz fiber filters was used for sampling. Inductively coupled plasma optical emission spectroscopy (ICP-OES) was also used for HMs analyses. Risk assessment and hazard index (HI) of these metals were computed by using USEPA's exposure parameters. The results showed that the average 24-h mass concentration of PM2.5 ranged from 22.09 to 292.45 µg/m3. The results also indicated that 95.65 and 82.61% of the samples were higher than WHO and EPA guidelines for 24-h PM2.5. Also there was no statistically significant relationship between wind direction and PM2.5.The average concentration levels of seven measured metals (Cd, Co, Cr, Fe, Ni, Pb, and V) in the PM2.5 samples were in the range of 6.03 ng/m3 to 1335.94 ng/m3, and the order of their concentration was Fe > Ni > Pb > Cr > Cd > V > Co. Principal component analysis (PCA) showed that PM2.5-bound heavy metals were categorized in three groups. The ecological risk level of calculated metals was very significant, and the major contribution of the ecological risk was related to Cd. The highest HQ in children and adults was related to Cr, and overall HI in children was higher than adults. Also the RI values of Cr in both groups of children and adults were indicated high risk of developing cancer in human.

Changing face of Candida colonization pattern in pediatric patients with hematological malignancy during repeated hospitalizations, results of a prospective observational study (2016-2017) in shiraz, Iran.

BACKGROUND: Surveillance of current changes in the epidemiology of Invasive Fungal Diseases (IFDs) as an important component of the antifungal stewardship programs (ASP), requires careful regular monitoring, especially in high-risk settings such as oncology centers. This study aimed to examine Candida colonization status and corresponding current changes in children with malignancy during repeated admissions and also investigate the possible epidemiological shifts after the implementation of ASP. METHODS: In this prospective observational study, all eligible patients younger than 18 years were recruited during 2016-2017 at Amir Medical Oncology Center (AMOC) in Shiraz, Iran. Totally, 136 patients were enrolled and 482 samples were collected from different sites (oral/nasal discharges, urine and stool). Weekly regular sampling was carried out during hospitalization. Candida colonization status and epidemiological changes were monitored during repeated admissions. Samples were cultivated on Sabouraud Dextrose agar medium and identified by Polymerase Chain Reaction -Restriction Fragment Length Polymorphism (PCR-RFLP). RESULTS: Estimated Candida colonization incidence was 59.9% (82/136) in our patients. Candida colonization was found to be higher in oral cavity and rectum than that in nasal cavity. Among those long-term follow ups and repetitive hospitalizations, a significant number of patients exhibited changes in their colonization patterns (37.7%). Candida colonization did not reveal any significant relationship with age, sex, oncologic diseases and degree of neutropenia. C. albicans (72.0%) was found as the most common Candida species in colonized patients, followed by C. krusei, C. kefyr, C. glabrata and C. parapsilosis. CONCLUSION: Given the high incidence of Candida infections in children with cancers, close monitoring of epidemiologic changes is essential for judicious management, based on local surveillance data and improvement of overall quality of care in high risk patients.

Investigation of the Physical, Chemical Characteristics and Microbial Contamination of the Indoor Swimming Pools

Objective: The aim of this study was to investigate the physical, chemical and microbiological contamination of indoor swimming pools. Methods: Pool water specimens were collected using a plastic polypropylene sterilized bottle. The physical and chemical qualities of the waters were analyzed in terms of temperature, turbidity, pH, and free residual chlorine, with the standard methods for the examination of water. Bacteriological (routine methods) and parasitological (molecular methods) tests were carried out on pools water. Results: The mean temperature, pH, and residual chlorine of the indoor pools were 31.2 °C, 7.6 and 1.5 mg/L, respectively. Turbidity was not observed in any of the pools. The pH and temperature values were in standard ranges in 92.3% and 15.4% of the waters of swimming pools, respectively. The prevalence rates of bacterial and amoebic contaminations of the water in the swimming pools were 53.8% and 46.2%, respectively. One pool (7.7%) was contaminated with both bacteria and amoeba. Streptococcus viridans, Staphylococcus epidermidis, Pseudomonas stutzeri, Cryptosporidium and Bacillus spp. were isolated from the pool waters. Conclusion: In this study, some microorganisms were identified from the water pools. Effective management of swimming pools and proper control of the physical, chemical and microbiological property of water pools can produce the healthy recreational activity.

Indicator bacteria community in seawater and coastal sediment: the Persian Gulf as a case.

BACKGROUND: The aim of present work was to assess the concentration levels as well as vertical distribution of indicator bacteria including total coliform, fecal coliform, Pseudomonas aeruginosa, and Heterotrophic Plate Count (HPC) in the marine environment (seawater and coastal sediments) and evaluate the correlation between indicator bacteria and some physicochemical parameters of surface sediments as well as seawaters. METHODS: A total number of 48 seawater and sediment samples were taken from 8 stations (each site 6 times with an interval time of 2 weeks) between June and September 2014. Seawater and sediment samples were collected from 30 cm under the surface samples and different sediment depths (0, 4, 7, 10, 15, and 20 cm) respectively, along the Persian Gulf in Bushehr coastal areas. RESULTS: Based on the results, the average numbers of bacterial indicators including total coliform, fecal coliform, and Pseudomonas aeruginosa as well as HPC in seawater samples were 1238.13, 150.87, 8.22 MPN/100 ml and 1742.91 CFU/ml, respectively, and in sediment samples at different depths (from 0-20 cm) varied between 25 × 103 to 51.67 × 103, 5.63 × 103 to 12.46 × 103, 17.33 to 65 MPN/100 ml, 36 × 103 to 147.5 × 103 CFU/ml, respectively. There were no statistically significant relationships between the indicator organism concentration levels with temperature as well as pH value of seawater. A reverse correlation was found between the level of indicator bacteria and salinity of seawater samples. Also results revealed that the sediment texture influenced abundance of indicators bacteria in sediments. As the concentration levels of indicators bacteria were higher in muddy sediments compare with sandy ones. CONCLUSION: Result conducted Bushehr coastal sediments constitute a reservoir of indicator bacteria, therefore, whole of the indicators determined were distinguished to be present in higher levels in sediments than in the overlying seawater. It was concluded that the concentration levels of microbial indicators decreased with depth in sediments. Except total coliform, the numbers of other bacteria including fecal coliform, Pseudomonas aeruginosa and HPC bacteria significantly declined in the depth between 10 and 15 cm.

LIF spectroscopy of stained malignant breast tissues.

We employ laser induced fluorescence (LIF) spectroscopy to discriminate between normal and cancerous human breast (in-vitro) tissues. LIF signals are usually enhanced by the exogenous agents such as Rhodamine 6G (Rd6G) and Coumarin 7 (C7). Although we observe fluorescence emissions in both fluorophores, Rd6G-stained tissues give notable spectral red shift in practice. The latter is a function of dye concentration embedded in tissues. We find that such red shifts have a strong dependence on the dye concentration in bare, in stained healthy, and in malignant breast tissues, signifying variations in tubular abundances. In fact, the heterogeneity of cancerous tissues is more prominent mainly due to their notable tubular densities- which can provide numerous micro-cavities to house more dye molecules. We show that this can be used to discriminate between the healthy and unhealthy specimens in different biological scaffolds of ordered (healthy) and disordered (cancerous) tissues. It is demonstrated that the quenching process of fluorophore' molecules slows down in the neoplastic tumors according to the micro-partitioning, too.

Laser induced breakdown spectroscopy and acoustic response techniques to discriminate healthy and cancerous breast tissues.

Laser induced breakdown spectroscopy and subsequent acoustic response during microplasma formation are employed to identify cancerous human breast tissues. The characteristic optical emissions identify Ca, Na, and Mg rich species in cancerous tissues compared to those of healthy ones. Furthermore, we show that the characteristic parameters of the microplasma, generated on the unhealthy tissues, are elevated. We report higher decibel audio signals emanating from laser induced microplasma and a subsequent audio blueshift for malignant tissues. The higher abundance of trace elements in cancerous tissues as well as higher plasma temperature and electron density in laser induced microplasma (leading to a stronger shockwave) intensify the acoustic signals.

Renal function in children with cyanotic congenital heart disease: pre- and post-cardiac surgery evaluation.

OBJECTIVE: Cyanotic congenital heart diseases (CCHDs) are a series of cardiac anomalies that have long been recognized as a potential cause of nephropathy. There have been few reports on renal impairment in patients with CCHD before and after corrective cardiac surgery. The aim of this study was to evaluate the prevalence of renal dysfunction before and after cardiac surgery and the impact of some risk factors on final renal outcome. METHODS: Thirty children with CCHD who had done corrective cardiac surgery in the previous 6 months were enrolled in this study. All data prior to surgery were collected from the charts. Post-operation data including blood and spot urine samples were taken simultaneously for CBC, Cr, and uric acid and 24 hour urine was collected for microalbumin and Cr during the follow up visits. Pre- and post-operation parameters were compared to study the impact of cardiac surgery on renal function. Findings : Pre- and post-operative GFRs were not significantly different. Final GFR was significantly and inversely associated with pre- and post-operation age (P=0.008 r=-0.48, P=0.03 r=-0.38). Three (10%) patients had microalbuminuria. The prevalence of microalbuminuria in children older than 10 years was 30%. There was no link between microalbuminuria and age, GFR, and hematocrit (P=0.1, P=0.3, P=0.3, respectively). Patients with preoperation hematocrit >45 had a significantly lower final GFR compared to children with HCT <45 (83.7±6.5 vs 111.10.2, P=0.001). The mean uric acid fraction (FEua) excretion was 8.21±4.75. Pre-operative HCT was inversely associated to FEua (P=0.01, r=-0.44). There was no relationship between FEua and age, serum uric acid, and GFR (P=0.7, P=0.4, P=0.2). CONCLUSION: Children with CCHD are at increased risk of renal injury which is related more to the duration of cyanosis and higher degree of hematocrit level. To lower the risk, corrective cardiac surgery is recommended to be done as soon as possible to improve renal function and stop more renal impairment.

Markov analysis and Kramers-Moyal expansion of nonstationary stochastic processes with application to the fluctuations in the oil price.

We describe a general method for analyzing a nonstationary stochastic process X(t) which, unlike many of the previous analysis methods, does not require X(t) to have any scaling feature. The method is used to study the fluctuations in the daily price of oil. It is shown that the returns time series, y(t)=ln[X(t+1)X(t)] , is a stationary and Markov process, characterized by a Markov time scale t_{M} . The coefficients of the Kramers-Moyal expansion for the probability density function P(y,tmid R:y_{0},t_{0}) are computed. P(y,tmid R:,y_{0},t_{0}) satisfies a Fokker-Planck equation, which is equivalent to a Langevin equation for y(t) that provides quantitative predictions for the oil price over times that are of the order of t_{M}. Also studied is the average frequency of positive-slope crossings, nu_{alpha};{+}=P(y_{i}>alpha,y_{i-1}