Investigation of the anisotropy and scaling of the phase structure function of a spatially coherent light beam propagating through convective air turbulence.

We report on applications of moiré deflectometry in measurements of the anisotropy and scaling of the phase structure function (PSF), obtained after passing a laser beam through an indoor enclosure containing convective air turbulence. We combine the use of two telescopes, with a two-channel wavefront sensor based on moiré deflectometry, to attain high sensitivity and resolution to fluctuations in the wavefront phase, caused by turbulent fluctuations in the enclosure. The measurements of the wavefront PSF along two directions perpendicular to the direction of the light beam propagation at different heater temperatures show that the convective air turbulence is anisotropic turbulence, where the value of the anisotropy increases with increasing temperature gradient. Various models are fitted to the measured PSFs, and we find that the turbulent is also non-Kolmogorov, in which, for the separation distances of two points on the wavefront less than 10 cm, the von Kármán PSF is the best fit to the experimental data. For higher values of separations, the experimental data do not fit with existing models. By fitting the von Kármán PSF on the data, we estimate values of the refractive index structure constant, Cn2, as well as the outer scale of the turbulence. The value of the outer scale decreases with increasing temperature of the heater up to approximately 50°C, where it saturates, while the value of Cn2 monotonically increases. Over the complete range of heater temperatures, from 40°C to 160°C, the Rayleigh number, Ra, for the enclosed air flow varied from 5.80×108

Quercetin and cancer: new insights into its therapeutic effects on ovarian cancer cells.

Ovarian cancer is known as a serious malignancy that affects women's reproductive tract and can considerably threat their health. A wide range of molecular mechanisms and genetic modifications have been involved in ovarian cancer pathogenesis making it difficult to develop effective therapeutic platforms. Hence, discovery and developing new therapeutic approaches are required. Medicinal plants, as a new source of drugs, could potentially be used alone or in combination with other medicines in the treatment of various cancers such as ovarian cancer. Among various natural compounds, quercetin has shown great anti-cancer and anti-inflammatory properties. In vitro and in vivo experiments have revealed that quercetin possesses a cytotoxic impact on ovarian cancer cells. Despite obtaining good results both in vitro and in vivo, few clinical studies have assessed the anti-cancer effects of quercetin particularly in the ovarian cancer. Therefore, it seems that further clinical studies may introduce quercetin as therapeutic agent alone or in combination with other chemotherapy drugs to the clinical setting. Here, we not only summarize the anti-cancer effects of quercetin but also highlight the therapeutic effects of quercetin in the ovarian cancer.

Cancer stem cells as therapeutic targets of pancreatic cancer.

The discovery of stem cells and their potential abilities in self-renewal and differentiation has opened a new horizon in medicine. Scientists have found a small population of stem cells in some types of cancers with the same functions as normal stem cells. There are two models for tumor progression: clonal (stochastic) and cancer stem cell (CSCs) models. According to the first model, all transformed cells in the tumor have carcinogenic potential and are able to proliferate and produce the same cells. The latter model, which has received more attention recently, considers the role of CSCs in drug resistance and tumor metastasis. Following the model, researchers have found that targeting CSCs may be a promising way in cancer therapy. This review describes CSC characteristics in general, while also focusing on CSC properties in the context of pancreatic cancer.

Acute purulent mediastinitis with sequential bilateral pleural empyema caused by neck trauma: A unique occurrence, a case report.

BACKGROUND: Descending necrotizing mediastinitis (DNM) due to blunt trauma is very rare form of mediastinitis that can rapidly progress to septicemia and multi organ failure, in spite of optimal surgical management. CASE PRESENTATION: We report a 28-year-old patient, previously healthy man, with acute descending necrotizing mediastinitis and late sequential bilateral pleural empyema, caused by blunt neck trauma. Although after admission, the course of his illness was complicated with septic shock, homodynamic instability, renal and pulmonary insufficiency, however he survived with on time diagnosis, aggressive surgical intervention, appropriate antibiotics administration and optimal management in the intensive care unit (ICU). CONCLUSIONS: Descending necrotizing mediastinitis due to blunt neck trauma is a rare occurrence, but can lead to late sequential bilateral empyema even after 18 days. With early diagnosis, aggressive drainage and antibiotic therapy, the patient life can be saved. The lesson we took from this case is that: 1- blunt neck trauma rarely leads to descending necrotizing mediastinitis and late sequential empyema (even after 18 days). 2- If the patient does not recover from sepsis, despite optimal surgical management, contra lateral empyema or pericarditis should be considered.

MicroRNAs and response to therapy in leukemia.

A variety of epigenetic factors involved in leukemia pathogenesis. Among various epigenetic factors, microRNAs (miRNAs) have emerged as important players, which affect a sequence of cellular and molecular signaling pathways. Leukemia is known as progressive cancer, which is related to many health problems in the world. It has been shown that the destruction of the blood-forming organs could lead to abnormal effects on the proliferation and development of leukocytes and their precursors. Despite many attempts for approved effective and powerful therapies for patients with leukemia, finding and developing new therapeutic approaches are required. One of the important aspects of leukemia therapy, identification of underlying cellular and molecular mechanisms involved in the pathogenesis of leukemia. Several miRNAs (ie, miR-103, miR-101, mit-7, let-7i, miR-424, miR-27a, and miR-29c) and play major roles in response to therapy in patients with leukemia. miRNAs exert their effects by targeting a variety of targets, which are associated with response to therapy in patients with leukemia. It seems that more understanding about the roles of miRNAs in response to therapy in patients with leukemia could contribute to better treatment of patients with leukemia. Here, for the first time, we summarized various miRNAs, which are involved in response to therapy in the treatment patients with leukemia.

Leukemia-derived exosomes: Bringing oncogenic signals to blood cells.

Leukemia is a cancer, which is derived from leukocytes and precursors of leukocytes in the bone marrow. A large number of pivotal biological processes are linked to leukemia pathogenesis. More insights into these mechanisms can provide a better developing pharmacological platform for patients with leukemia. Among the different players in leukemia pathogenesis, exosomes have appeared as a new biological vehicle, which can transfer oncogenic signals to blood cells. Exosomes are nano-carriers, which enable transferring numerous cargos such as DNA fragments, RNAs, messenger RNAs, microRNAs, long noncoding RNA, and proteins. Targeting the contents of exosomes leads to the alteration of host cell behavior. Increasing evidence has indicated that leukemia-derived exosomes could be utilized as prognostic, diagnostic, and therapeutic biomarkers for individuals suffering from leukemia. In this regard, the importance of exosomes in terms of initiation and progression of leukemia was underlined in this study.

MicroRNA: A new player in response to therapy for colorectal cancer.

Colorectal cancer (CRC) is one of the important malignancies that result in cancer-related deaths worldwide. Multiple lines of evidence have indicated that different responses to therapy in CRC cells led to the failure of the current therapies. Hence, identification of the underlying cellular and molecular pathways involved in the emergence of different responses from CRC cells could contribute to finding and designing new therapeutic platforms to overcome the present limitations. Among the various targets involved in CRC pathogenesis, microRNAs (miRNAs) have key roles in many signaling pathways that are associated with the initiation and progression of CRC. Increasing evidence has confirmed that miRNAs as epigenetic regulators could play critical roles in the response (resistance or sensitivity) to therapy. Cancer stem cells are well-known players in resistance to therapy in CRC. They have been shown to play significant roles via inhibition and activation of many miRNA networks. Hence, miRNAs could be involved in the resistance and sensitivity of therapy in CRC cells via affecting different mechanisms, such as activation of cancer stem cells. Here, we summarized the role of various miRNAs in response to therapy of CRC cells. Moreover, we highlighted the roles of these molecules in the function of cancer stem cells, which are known as important players in the resistance to therapy in CRC.

Vaccines for colorectal cancer: an update.

Colorectal cancer (CRC) is known as the third most common and fourth leading cancer associated death worldwide. The occurrence of metastasis has remained as a critical challenge in CRC, so that distant metastasis (mostly to the liver) has been manifested in about 20%-25% of patients. Several screening approaches have introduced for detecting CRC in different stages particularly in early stages. The standard treatments for CRC are surgery, chemotherapy and radiotherapy, in alone or combination. Immunotherapy is a set of novel approaches with the aim of remodeling the immune system battle with metastatic cancer cells, such as immunomodulatory monoclonal antibodies (immune checkpoint inhibitors), adoptive cell transfer (ACT) and cancer vaccine. Cancer vaccines are designed to trigger the intense response of immune system to tumor-specific antigens. In two last decades, introduction of new cancer vaccines and designing several clinical trials with vaccine therapy, have been taken into consideration in colon cancer patients. This review will describe the treatment approaches with the special attention to vaccines applied to treat colorectal cancer.

The relationship between socioeconomic status and trauma outcomes.

Background: The burden of trauma is not equally distributed among all groups of societies and often disproportionately affects poor populations. This study aimed to examine the relationship of socioeconomic status (SES) and trauma outcomes. Methods: In this cohort study, 600 trauma patients in Kashan, Iran were studied. Data were gathered by demographic and trauma-related questionnaires, a socioeconomic assessment scale, the Hospital Care Index and the World Health Organization Disability Assessment Schedule-II. The concentration index was done for measuring socioeconomic inequalities. Results: About 49.7% of the patients received high level of hospital care. After 3 months from trauma incidence, 64.2% of the patients reported some levels of disability and 71.4% returned to their work or activities of daily living. Most cases of high level of hospital care and return to work (RTW) were among patients with high SES while most instances of death and disability occurred among patients with low SES. Inequality analysis also revealed that patients with low and high SES differed significantly from each other in terms of hospital care and RTW. Conclusion: Patients with low SES are at greater risk for receiving low level of hospital care and experiencing non-RTW and needs to stronger post-discharge social supports.

Pleural effusion as a rare manifestation of mediastinal teratoma: A case report.

Pleural effusion as one of the most common manifestations of pulmonary diseases is a rare symptom of anterior mediastinal teratoma that might mislead general physicians. In this study we report a rare case of pleural effusion and anterior mediastinal teratoma accompanying each other. The patient was a 21-year-old woman who suffered from dyspnea, cough, fever and manifestations of pleural effusion were obvious in chest X Ray (CXR). Computed tomography scan showed a cystic mass with lipid component. After thoracotomy, a mass was taken out from medial lobe of right lung and the results of pathology showed the mature mediastinal teratoma. The patient remained well with no evidence of recurrence on follow-up CXRs 6 months after the surgery.

Return to work after trauma: A survival analysis.

PURPOSE: To evaluate the return to work (RTW) rate, time and predictors among trauma patients using survival analysis. METHODS: This cohort study was conducted with a three-month follow-up on 300 trauma patients hospitalized in Shahid Beheshti Hospital, Kashan, Iran in 2014. The data were collected through conducting interviews and referring to patients' medical records during their hospital stay and follow-up information at one & three months after discharge from hospital. Final analysis was conducted on the data retrieved from 273 patients. Data were analyzed by chi-square test, Mann-Whitney U test and survival analysis method. RESULTS: The rate of RTW at the end of the first and the third follow-up months was respectively 21.6% and 61.2%. Survival analysis showed that the RTW time (Time between admission to first return to work) was significantly longer among patients with illiteracy, drug abuse, hospitalization history in the intensive care unit, low socioeconomic status, non-insurance coverage, longer hospital stay, multiple and severe injuries as well as severe disability. CONCLUSION: Our findings indicated that trauma has profound effects on the rate and time of RTW. Besides disability, many personal and clinical factors can affect the outcome of RTW.

Psychometric properties of the world health organization disability assessment schedule II -12 Item (WHODAS II) in trauma patients.

BACKGROUND: The 12-item WHODAS II is widely used for assessing disability among different populations. This study aimed at assessing the psychometric properties of the Persian version of the 12-item WHODAS II among trauma patients. PATIENTS AND METHODS: In this methodological study, 220 patients aging 15-65-year-old hospitalized in Shahid Beheshti Hospital, Kashan, Iran, were studied. The WHODAS II was used for data collection. The reliability of this schedule was assessed by evaluating its internal consistency. Its validity was evaluated by using the known-groups approach and the convergent validity method. The exploratory and the confirmatory factor analysis techniques were also used for assessing the factor structure of the schedule. RESULTS: The mean of participants' ages was 34.7±14.5 years. Most of the participants were male patients (84.1%), had multiple injury (77.7%), and had been injured in road traffic accidents (76.8%). The Cronbach's alpha of the WHODAS II was 0.91, confirming its acceptable internal consistency. Known-groups comparisons revealed that this schedule can satisfactorily differentiate among patients with different severity of trauma (P value<0.0001). The results of exploratory factor analysis showed that the WHODAS II had a two-factor structure while the confirmatory factor analysis revealed that one-factor model fitted the data. CONCLUSION: Study findings suggest that the Persian version of the 12-item WHODAS II is a valid and reliable scale for assessing trauma patients' disability. More Large-scale studies are needed for assessing the validity and the reliability of this schedule among other patients.

Measurement of Disability and Its Predictors Among Trauma Patients: A Follow-up Study.

BACKGROUND: Globally more than a billion people, 15% of the population, lives with disability and most of disabilities are caused by injuries. OBJECTIVES: The aim of this study was to describe the prevalence of disability and its predictors at 1 and 3 months post-injury in Kashan City during 2014 - 2015. PATIENTS AND METHODS: In this longitudinal follow-up study, 400 injured patients 15 - 65 years referred to Shahid Beheshti hospital in Kashan and hospitalized more than 24 hours were assessed for disability status with the WHODAS II 12-item instrument at 1 and 3-months post-injury. Patients based on their disability scores were divided into 5 groups: none, mild, moderate, severe and very severe. Work status was assessed at the 3-month follow-up with one question "Are you back at work following your injury". Also, demographic characteristics and information about injury were gathered by a checklist. Data were analyzed using chi-square, Mann-Whitney U, Kruskal Wallis, Pearson correlation coefficient and logistic regression by SPSS software. The significance level was set at P < 0.05. RESULTS: The mean disability scores at 1 and 3 months post-injury was 30.3 (9.2) and 18.8 (8.3), respectively and there was a statistical significant difference between disability status at 1 and 3 months after trauma (P < 0.0001). The rates of return to work in 262 employed patients at 1 and 3 months after injury were 29% and 55.4%, respectively. The disability score showed a statistically significant correlation with Injury Severity Score (ISS) (P < 0.0001), work return (P = 0.033), intensive care unit transfer (P < 0.0001), trauma type (P = 0.001) and age (P = 0.004). Also, age, ISS, duration of hospital stay and injury to extremities were predictors of disability. CONCLUSIONS: More than half of the patients were disabled after 3 months of trauma. Elderly patients, patient with severe trauma, and long hospitalization and patients with extremity injuries were high risk for disability.

Influence of body mass indexes on response to treatment in acute asthma.

Increases in body mass index (BMI) are reported to influence asthma response to treatment. The aim of this study was to investigate the relationship between BMI and response to treatment in a group of patients that were referred for asthma control. Effectiveness measurements in this analysis included percentage of changes in forced volume in 1 second (FEV1), forced volume capacity (FVC), FEV1/FVC, and forced expiratory flow between 25% and 75% of FVC (FEF25-75%). A total of 293 subjects with asthma of both genders and above 18 years of age were divided into the following BMI categories: 107 (36.5%) non-obese (BMI < 25), 186 (63.5%) overweight and obese (BMI ≥ 25). Percentage of change was defined as change in variable between baseline and end-of-treatment. Analyses of non-obese vs. overweight/obese asthmatics demonstrated non-significant differences in baseline FEV1 (1.62 ± 0.56 Lit vs. 1.63 ± 0.56 Lit L, P = 0.89); FVC (2.58 ± 0.73 Lit vs. 2.47 ± 0.82 Lit, P = 0.25); and FEF25-75% (1.04 ± 0.55 ml/sec vs. 1.05 ± 0.50 ml/sec, P = 0.47) respectively. Compared with non-obese subjects, in overweight/obese subjects with asthma were less responded to treatment. Percentage changes of FEV1, FVC, FEF25-75%, and FEV1/FVC in non-obese versus obese/overweight patients were: 79.57 ± 55.14 % vs. 62.13 ± 41.72%, P = 0.005; 47.71 ± 33.76% vs. 39.93 ± 28.30%, P = 0.036; 151.98 ± 127.82% vs. 123 ± 91.12%, P = 0.041; 20.54 ± 15.63% vs. 15.63 ± 11.32%, P = 0.005; respectively. Percentage changes of spirometric values to treatment in over weight/obese asthmatic patient were lesser in compared with non-obese subjects.

Spontaneous esophageal perforation presenting as a right-sided pleural effusion: a case report.

Spontaneous esophageal perforation or Boerhaave's syndrome is an uncommon condition that may occur following forceful vomiting and lead to mediastinitis. It is associated with high mortality and morbidity in absence of therapy. We present a case of spontaneous esophageal perforation in a 63 year-old man who developed a right-sided effusion, an unusual presentation. This case report and the relevant literature reveal that delay in prompt surgical repair is associated with a high morbidity and mortality.

Evaluation of high-sensitivity C-reactive protein in acute asthma.

BACKGROUND: High sensitivity C-reactive protein (hs-CRP) is an inflammatory marker known to be related to inflammation, infection, and cardiovascular diseases. The aim of this study was to evaluate hs-CRP level in serum of asthmatics and its relationship with pulmonary function tests, serum IgE levels, and peripheral blood white blood cell (WBC) counts. MATERIALS AND METHODS: The under study subjects were 108 patients with acute asthma and 93 healthy volunteers. The levels of hs-CRP of 108 patients with acute bronchial asthma and 93 non-asthmatic control subjects were measured. Spirometry, serum immunoglobulin-E (IgE) measurement, and WBC counts were done for patient and control groups. RESULTS: The mean serum hs-CRP levels were significantly higher in patients with acute asthma compared with controls (5.47±7.33 mg/l versus 1.46± 1.89 mg/l, p < 0.001). Among asthmatic patients, mean hs-CRP levels were not correlated with indices of pulmonary function tests (forced expiratory volume in one second, forced vital capacity and forced mid-expiratory flow), serum IgE level, eosinophil count or WBC count. CONCLUSION: Serum C-reactive protein levels measured by high-sensitivity assays increase in acute asthma and may be useful as a diagnostic tool for detecting and monitoring inflammation in these patients. In our study on patients with acute asthma, no significant correlation was revealed between hs-CRP and pulmonary function tests, total serum IgE, or peripheral blood white blood cell counts.

Effect of age on response to treatment in adult patients with severe persistent asthma.

BACKGROUND: Due to current controversies regarding the effect of age on response to treatment in asthmatic patient, the present study was performed on patients referred with acute asthma attack for further evaluation of this matter. MATERIALS AND METHODS: In this study 138 patients with severe persistent asthma were enrolled and divided into two categories of young (age ≤35 yrs; 82 cases, mean age = 25.2±7.3 years) and elderly subjects (≥50 yrs; 56 cases, mean age 57.4±6.4 years). Response to treatment was determined by pulmonary function tests. RESULTS: The mean percentage change of FEV1 from baseline in male and female patients of young and old age was 75.05±46.61 and 71.39±41.30%, (P = 0.721) and 100.79±51.34% and 69±37.39% (P = 0.015), respectively. The mean percentage of possible improvement of FEV1 among male and female patients of young and old age was 62.81±25.67% and 54.46±23.82% (P = 0.148), and 78±24.04% and 63.58±41.24% (P = 0.087); respectively. CONCLUSION: Response to treatment was significant in both young and old age groups suffering from acute asthmatic attack except for young female patients in which, percentage change of FEV1 increased compared to older patients. Among other patients this value and percentage of possible improvement of FEV1 between the 2 groups did not change significantly and age did not play a significant role in assessing the response to treatment in acute asthmatic attack.

Correlation of arterial blood gas measurements with venous blood gas values in mechanically ventilated patients.

BACKGROUND: Arterial blood gas (ABG) analysis is useful in evaluation of the clinical condition of critically ill patients; however, arterial puncture or insertion of an arterial catheter may cause many complications. The aim of this study was to determine whether venous blood gas (VBG) values can be used as an alternative to arterial blood gas measurements in patients under mechanical ventilation. MATERIALS AND METHODS: This study was carried out on patients admitted to the Intensive Care Unit of Kashan Beheshti Hospital. Blood for VBG analysis was obtained from the cubital vein, while for ABG analysis blood was taken simultaneously from the radial artery. ABG and VBG samples were obtained simultaneously, and indexes of pH, PCO2, HCO3, base excess (BE), PO2 and O2 saturation level were analyzed. RESULTS: A total of 102 pair of simultaneous venous and arterial blood samples were obtained from 102 patients (mean age 58.4±21.5 years). Seventy (69%) were males. The mean difference between arterial and venous values was 0.04 for pH, 5.6 mm/Hg for PCO2, -0.32 mmol/l for HCO3, -1.03 mmol/l for BE, 53.6 mm/Hg for PO2, and 23.5% for O2 saturation. The Pearson correlation coefficients between arterial and venous values for pH, PCO2, HCO3, BE, PO2 and O2 saturation were 0.874, 0.835, 0.768, 0.810, 0.287, and 0.310, respectively. Linear regression equations for the estimation of pH, PCO2, HCO3, BE, PO2 and O2 saturation were as follows: arterial pH=1.927+0.745×venous pH [r=0.801, p<0.001]; PCO2=6.470+0.706×venous PCO2 [r=0.835, p<0.001]; arterial HCO3=7.455+0.681×venous HCO3 [r=0.768, p<0.001]; arterial BE=-0.952+0.736×venous BE [r=0.810, p<0.001]; arterial PO2=70.374+0.620×venous PO2 [r=0.287, p=0.003]; arterial venous saturation= 89.753+0.082×venous O2 saturation [r=0.317, p=0.001]. CONCLUSION: Venous blood gases, especially pH, Base excess, and PCO2 levels have relatively good correlation with ABG values. Because this correlation is not close, VBG cannot substitute ABG in mechanically ventilated patients.

Correlation of end-tidal carbon dioxide with arterial carbon dioxide in mechanically ventilated patients.

BACKGROUND: Patients undergone mechanical ventilation need rapid and reliable evaluation of their respiratory status. Monitoring of End-tidal carbon dioxide (ETCO2) as a surrogate, noninvasive measurement of arterial carbon dioxide (PaCO2) is one of the methods used for this purpose in intubated patients. OBJECTIVES: The aim of the present trial was to study the relationship between end-tidal CO2 tensions with PaCO2 measurements in mechanically ventilated patients. MATERIALS AND METHODS: End-tidal carbon dioxide levels were recorded at the time of arterial blood gas sampling. Patients who were undergoing one of the mechanical ventilation methods such as: synchronized mandatory mechanical ventilation (SIMV), continuous positive airway pressure (CPAP) and T-Tube were enrolled in this study. The difference between ETCO2 and PaCO2 was tested with a paired t-test. The correlation of end-tidal carbon dioxide to (ETCO2) CO2 was obtained in all patients. RESULTS: A total of 219 arterial blood gases were obtained from 87 patients (mean age, 71.7 ± 15.1 years). Statistical analysis demonstrated a good correlation between the mean of ETCO2 and PaCO2 in each of the modes of SIMV, CPAP and T-Tube; SIMV (42.5 ± 17.3 and 45.8 ± 17.1; r = 0.893, P < 0.0001), CPAP (37 ± 9.7 and 39.4 ± 10.1; r = 0.841, P < 0.0001) and T-Tube (36.1 ± 9.9 and 39.4 ± 11; r = 0.923, P < 0.0001), respectively. CONCLUSIONS: End-tidal CO2 measurement provides an accurate estimation of PaCO2 in mechanically ventilated patients. Its use may reduce the need for invasive monitoring and/or repeated arterial blood gas analyses.