RESUMO
Background: Cardiotoxicity of anthracyclines [ANTs] in medium and high doses [more than 350 mg/m[2]]has been already known but it is still unclear whether or not minimal doses ]lower than 350 mg/m[2]] can also affect cardiac function
The goal of this study was to assess the cardiotoxicity of ANTs in children under minimal doses and evaluation the association of this toxicity with probable risk factors such as age at beginning of regimen, gender or type of malignancy
Methods: In a prospective study 50 children suffering from different malignancies admitted in pediatric oncology department of Besat Hospital of Sanandaj City in 2010-2012, under ANTs regimen [Daunorubicin, Doxorubicin] in doses lower than 350 mg/m[2] were followed by serial echocardiography for 1-3 years
The deviation from normal values of echocardiographic parameters was measured for all patients in this period and even one parameter's deviation was considered as cardiac dysfunction and ANTs cardiotoxicity
The association of this toxicity and probable risk factors was analyzed by proper statistical methods in SPSS 18th version
Results: In 22% of patients, mostly children older than 11, at least one of echocardiographic parameters including: ejection fraction [EF], left ventricular end systolic diameter [LVESD], left ventricular end diastolic diameter [LVEDD], left ventricular mass [LVM] and left ventricular posterior wall diameter [LVPWD] changed during our follow up. The most important risk factor for cardiotoxicity in this study was age at beginning of ANTs regimen
Acute myeloid leukemia [AML] had the most abnormal values among all types of malignancies
In this study there was no statistically significant association between cardiotoxicity and gender or duration of follow up
Conclusion: Anthracyclines even in doses lower than 350 mg/m2 can induce cardiac dysfunction and alter echocardiographic parameters, although these changes are not always accompanied by clinical signs or symptoms as they were in this study
So long term echocardiographic follow up and cardioprotective techniques are recommended in prescription any doses of these cardiotoxic drugs
RESUMO
To assess the epidemiologic features of shigellosis in Iranian military personnel of the Army. The data was gathered from archived reports of Iran's Army at AJA University of Medical Sciences. All military personnel with confirmed diagnosis of shigellosis reported by the Army physicians were included in the study. Data analysis was done by appropriate statistical functions using STATA software. In a 7-year period [2005-2011] the total number of cases was 1710 from 25 provinces of Iran. A large difference was found out in the incidence rates of different provinces. 69% of all cases were from the five provinces of Hormozgan, Khuzestan, Sistan-Baluchistan, Bushehr and Guilan. Although the majority [55%] of the cases had occurred in spring, the association between season and incidence rate was not significant [P = .08]. Among the three studied forces 45% of reported patients were from Navy. The overall occurrence of shigellosis has decreased among Iranian army personnel from 2005 to 2011, but the incidence is still high enough to be considered as a major problem. Army healthcare commanders are expected to improve necessary facilities, especially in the Navy and in endemic provinces, to decrease the transmission of this infection.