The Prevalence of fungal infections in children with hematologic malignancy in Ali-Asghar Children Hospital between 2005 and 2010.

BACKGROUND: A fungal infection represents a growing problem in children with hematologic malignancies, during chemotherapy induced neutropenia. Fungal colonization is considered a major risk factor for subsequent fungal infections. The aim of this retrospective study was to evaluate prevalence of fungal infection among children admitted to hospital between 2005 and 2010 in Tehran, Iran. MATERIALS AND METHODS: 617 hematological patients in the age range of neoteric to 19 years old were enrolled and 87 cases with invasive fungal infections were extracted from patients' files and documented. Diagnosis of fungal infections was based on the local biopsy and pathology for mucormycosis, blood culture, urine culture and clinical examination for candidasis and galactomannan for aspergillus. RESULTS: the mean age of cancer diagnosis was 6.33 years old and the mean age of fungal infection was 7.95 years old. The majority of the infections was caused by candidia spp (74.7%), followed by aspergillus spp (17.2%) and zygomycetes (11.5%). Among candidiasis patients, oral infection had the highest manifestation (92.3%) whereas in 10 of 15 patients with aspergillus, the infectious site was the lung. There was a significant association between mortality and the type of fungal infection (p <0.0001). CONCLUSION: Our finding suggests that there is a high rate of fungal infections in children receiving remission therapy for onco-hematology. These results help improve the management of these patients, however Further studies are needed.

Effect of heterozygous beta-thalassaemia trait on coronary atherosclerosis via coronary artery disease risk factors: a preliminary study.

BACKGROUND: Thalassaemia is considered the most common genetic disorder worldwide. An association between the heterozygous beta-thalassaemia trait and myocardial infarction has previously been observed. However, the relationship between heterozygous beta-thalassaemia and atherosclerosis, considering other coronary artery disease (CAD) risk factors, has remained unclear. METHODS: A case-control study was conducted to evaluate the hypothesis that thalassaemia minor affects the likelihood of atherosclerotic plaque formation. Blood counts and blood chemistry data as well as traditional risk factors from 1,363 patients referred to heart centres for coronary angiography were recorded. Heterozygous beta-thalassaemia was diagnosed by the presence of hypochoromic-microcytic anaemia, ferritin levels > 12 ng/ml and haemoglobin-A2 levels > 3.5. RESULTS: Chi-squared analysis showed that the prevalence of heterozygous beta-thalassaemia was not significantly different between patients with and without CAD (p > 0.05). Multivariate logistic regression analysis using CAD as the dependent variable and traditional risk factors, haematocrit, ferritin levels and heterozygous beta-thalassaemia as independent variables, did not show any significant difference either. Independent two-tailed student's t-tests showed that haematocrit levels were statistically different (p = 0.000) between CAD(+) and CAD(-) groups, but low-density lipids (LDL), high-density lipids (HDL), triglycerides (TG), total cholesterol and serum ferritin levels were not statistically different (p > 0.05). CONCLUSION: The prevalence of heterozygous beta-thalassaemia in the case group was not significantly different from the control group. This case-control study did not support the hypothesis that thalassaemia minor affects the likelihood of atherosclerotic plaque formation.

Uric acid: a risk factor for coronary atherosclerosis?

BACKGROUND AND OBJECTIVES: It is uncertain whether high serum uric acid levels are a true independent risk factor for coronary atherosclerosis or whether the association is due to other confounding variables. We therefore studied the relationship between elevated serum uric acid levels and coronary atherosclerosis after adjustment was made for confounding factors such as age, gender, body mass index, smoking, lipid profile, blood pressure and blood glucose levels. METHODS: A cross-sectional study was conducted on 240 patients referred for coronary angiography to heart centres in the Shahid-Chamran and Sina hospitals, Isfahan, Iran. Blood chemistry data as well as traditional risk factors and uric acid levels were measured at enrollment. We used vessel, stenosis and extent scores to indicate the degree of coronary artery involvement. RESULTS: This study was conducted on 240 patients with a mean age of 56 +/- 10.9 years (66% male; 37% female) who underwent coronary angiography. Student's t-test analyses revealed that there were significant differences in the mean uric acid levels between male and female patients (p = 0.001). We found no statistically significant correlation between serum uric acid levels and coronary atherosclerosis (p > 0.05). In addition, multivariate logistic regression analyses, using coronary atherosclerosis as dependent variable and traditional risk factors and uric acid levels as independent variables, did not show any significant difference. CONCLUSION: These findings indicated that uric acid is not associated with coronary atherosclerosis. Any correlation reported in other studies was probably due to the relationship between high serum uric acid levels and other cardiovascular risk factors.