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Tanaffos Respiration Journal - Volume:15 Issue: 2, Spring 2016

Tanaffos Respiration Journal
Volume:15 Issue: 2, Spring 2016

  • تاریخ انتشار: 1395/04/04
  • تعداد عناوین: 11
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  • Pardis Ghafarian, Hamidreza Jamaati *, Seyed Mohammadreza Hashemian Pages 61-69
    Input impedance of the respiratory system is measured by forced oscillation technique (FOT). Multiple prior studies have attempted to match the electromechanical models of the respiratory system to impedance data. Since the mechanical behavior of airways and the respiratory system as a whole are similar to an electrical circuit in a combination of series and parallel formats some theories were introduced according to this issue. It should be noted that, the number of elements used in these models might be less than those required due to the complexity of the pulmonary-chest wall anatomy. Various respiratory models have been proposed based on this idea in order to demonstrate and assess the different parts of respiratory system related to children and adults data. With regard to our knowledge, some of famous respiratory models in related to obstructive, restrictive diseases and also Acute Respiratory Distress Syndrome (ARDS) are reviewed in this article.
    Keywords: Respiratory impedance, Respiratory resistance, Respiratory reactance, Compliance, Respiratory modeling, Forced oscillation technique
  • Moein Foroughi, Hossein Razavi, Majid Malekmohammad, Parisa Adimi Naghan*, Hamidreza Jamaati Pages 70-74
    Obstructive sleep apnea (OSA) is a common disorder associated with major comorbidities. It is estimated that 5-35% of the adult population in Iran are at high risk for OSA. This review article is designed to assist sleep medicine specialists as well as general practitioners in Iran to screen for OSA. It summarizes empirical data for diagnosing OSA including history taking, physical examination, diagnostic testing, and diagnostic criteria with regards to existing sleep medicine centers and availability of diagnostic tests in Iran.
    Keywords: Obstructive Sleep Apnea Syndrome, Sleep, Disordered Breathing, Clinical Guideline
  • Amin Torabipour *, Ashrafalsadat Hakim, Kambiz Ahmadi Angali, Marzieh Dolatshah, Maryam Yusofzadeh Pages 75-82
    Background
    Chronic obstructive pulmonary disease (COPD) is a common disease with important healthcare, social, and economic consequences. The aim of this study was to analyze the costs of hospitalizing patients with COPD.
    Materials And Methods
    In this state-level cross-sectional study, data from 165 COPD patients who had presented to our hospital between April 1, 2011 and March 31, 2013 were reviewed retrospectively. Patients were eligible for inclusion if they had a diagnosis of COPD [international classification of diseases-10 (ICD-10) code J44]. Costs of COPD patients were calculated by multiplying the amount of services used by the unit cost. Finally, we used multivariate regression analysis to determine predictors of hospital costs.
    Results
    Mean (SD) age of the patients was 68.6 ± 12 years and 65.5% of them were ≥ 65. The mean (SD) and median length of stay (LOS) for patients were 8.5 ± 11.5 and five days [IQR 3; 9], respectively. All hospital cost drivers had significant relationships with LOS, and the mean cost per patient was higher in patients with hospital LOS longer than nine days. Prolonged LOS (LOS > 9 days) involved 830 bed/days. Therefore, the mean cost per each extra day of hospital stay was estimated to be US $115.80. The mean costs per patient with and without hypertension were US $1,422.5 and US $627.4, respectively (P=0.017).
    Conclusion
    Hospitalization and medication costs were the two major cost drivers for patients hospitalized with COPD exacerbation. Duration of hospital stay, history of hypertension, and the number of clinical consultations other were significant predictors associated with hospital cost in patients with COPD.
    Keywords: Hospital Costs, Chronic Obstructive Pulmonary Disease, Length of Stay
  • Sasan Tavana *, Samaneh Mirzaei Pages 83-88
    Background
    There is evidence of musculoskeletal and respiratory involvement in patients with chronic kidney disease (CKD). This is attributed to protein calorie imbalance that is caused by the disease process, and hemodialysis and is generally referred to as uremic myopathy. This results in calcification of respiratory muscles such as diaphragm and intercostal muscles. There are limited data about respiratory muscle strength in patients with CKD. We intended to evaluate the effect of kidney transplantation on respiratory muscles strength in patients with CKD.
    Materials And Methods
    Spirometry was used to measure maximal inspiratory mouth pressure (PIMAX), which was calculated by using the lung residual volume and maximal respiratory pressures at the mouth (PEMAX), 2 days before and again 30 days after kidney transplantation in 26 patients with ESRD. PIMAX and PEMAX values less than 60% of the predicted value were considered abnormal.
    Results
    Mean ± SD PIMAX values showed significant increase from 31.88 ± 8.58 cmH2O before kidney transplantation to 37.65 ± 13.39 cmH2O after transplant (P
    Conclusion
    Although both PIMAX and PEMAX values increased significantly after kidney transplant, these measurements were still below lower limit of normal. This suggests that factors other than uremic myopathy may contribute to respiratory muscle weakness in patients CKD.
    Keywords: Chronic kidney disease, Kidney transplant, Maximal inspiratory pressure (PIMAX), Maximal expiratory pressures (PEMAX)
  • Seyed Mohammadreza Hashemian, Hamidreza Jamaati, Behrooz Farzanegan Bidgoli, Farin Rashid Farrokhi, Majid Malekmohammad, Sepehr Roozdar *, Seyed Amir Mohajerani, Ahmad Bagheri, Golnar Radmnand, Behzad Hatami, Mandana Chitsazan Pages 89-95
    Background
    Acute Kidney Injury (AKI) is an unsolved clinical problem in critical care patients with a high mortality rate, increasing incidence, and no definitive therapy. We studied the incidence, risk factors, and mortality associated with AKI in ICU patients.
    Materials And Methods
    In a prospective study, patient demographics, reason for hospitalization, reason for ICU admission, Length of ICU stay, laboratory data, and Vital signs were recorded in prepared forms during the ICU stay. AKI was defined as an increase in serum creatinine (SCr) of ≥ 0.3mg/dl from the baseline.
    Results
    A total of 200 patients who were enrolled in our study; 134 (67%) did not develop AKI during their ICU stay while 66 (33%) developed AKI (SCr ≥ 0.3) according to the AKIN definition. Patients with AKI had higher APACHE II scores (12.3±5.6 vs. 6.9±3.6; P
    Conclusion
    The AKIN criteria are clinically valid and can be a good predictor of mortality and patient outcome in addition to APACHE II score in ICU patients.
    Keywords: Acute kidney injury, Intensive care unit, Glomerular filtration rate
  • Vahan Moradians, Alireza Rahimi, Seyed Ali Javadmoosavi, Fateme Sadat Sahebkar Khorasani, Ali Mazaherinejad, Masoud Mortezazade, Hanieh Raji * Pages 96-100
    Background
    There are not many studies about the effects of physical activity on pulmonary function in normal population. However, it seems that strengthening and persevering respiratory muscles is an effective technique for improving pulmonary function.
    Objective
    The purpose of this study was to evaluate and compare the effects of eight-week aerobic, resistance, and interval exercise routines on respiratory parameters in non-athlete women.
    Materials And Methods
    Thirty-six non-athlete women between 18-25 years old participated in this prospective quasi-experimental trial. The subjects were randomly divided into three groups (aerobic, resistance and interval exercise, 12 in each group). Each group exercised three times a week for a total of eight weeks (24 sessions in total). Pulmonary function tests (PFT), including tidal volume (VT), inspiratory reserve volume (IRV), expiratory reserve volume (ERV), inspiratory capacity (IC), vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in the first seconds (FEV1), the ratio of FEV1/FVC, peak inspiratory flow (PIF), and forced expiratory flow (FEF 25-75%) were recorded before and after the implementation of the exercise program for all participants. Data were analyzed using paired t-test and one-way ANOVA.
    Results
    The mean age of participants was 20.17 ± 2.13. The results of the paired T-test indicated that VC significantly increased in the group assigned to aerobic exercise (P = 0.028), while IC (P = 0.012) and PIF (P = 0.019) significantly increased in the group assigned to interval training.
    Conclusion
    Our results showed that interval and aerobic exercise routines could improve pulmonary functions and aerobic and interval training can be used to increase VC, IC, PIF, in non-athlete women.
    Keywords: Aerobic exercise, Resistive exercise, Spirometry, Physical activity
  • Khadijeh Nasiriani, Fakhri Torki *, Mohammad Hossein Jarahzadeh, Fahimeh Rashidimaybodi Pages 101-107
    Background
    Ventilator-associated pneumonia (VAP) is a common nosocomial infection, which results in longer hospitalization, increased treatment costs, and higher mortality rates. One major cause of VAP is colonization and microaspiration of oropharyngeal secretions following the formation of dental plaque, which is due to poor oral hygiene and failure to mechanically remove these microorganisms from the teeth. This study was conducted to determine the effect of brushing teeth with distilled water on the incidence of VAP in patients admitted to intensive care unit (ICU).
    Materials And Methods
    In this randomized clinical trial, 168 intubated patients, who had at least 20 teeth were randomly assigned to two groups. In the experimental group, the patients’ teeth were brushed twice a day with a children’s toothbrush and distilled water in addition to the routine oral care. The clinical pulmonary infection score (CPIS) was used to diagnose VAP. The data were analyzed using SPSS version 16 software.
    Results
    A total of 38.6% of the patients in each group developed VAP. There was a significant difference in incidence of VAP on day five between the two groups (P
    Conclusion
    According to our results, tooth brushing twice daily with distilled water reduced the incidence of VAP in patients admitted to the ICU. Therefore, it is recommended that nurses caring for ventilator-dependent patients brush the patients’ teeth with distilled water as a part of their routine oral care.
    Keywords: Distilled water, Oral hygiene, Ventilator associated pneumonia (VAP), Tooth brushing
  • Mashallah Aghilinejad, Elaheh Kabirmokamelkhah*, Mohammad Hassan Nassirikashani, Amir Bahrami-Ahmadi, Atefeh Dehghani Pages 108-111
    Background
    Workers in shipyard companies are exposed to different respiratory hazards. The present case-control study was designed to evaluate pulmonary function tests and respiratory symptoms among shipyard workers in Asaluyeh city in Southwest Iran.
    Material and
    Method
    Between March and October 2015 we recruited participants from two separate populations: shipyard workers as cases and office workers from the same shipyard company, who are not exposed to the same respiratory hazards, as controls. History was obtained from all participants and they all underwent physical examination and spirometry.
    Results
    Respiratory signs and symptoms were present in a significantly higher number of shipyard workers compared to the unexposed office workers. Similarly, there were significant spirometric differences between cases and controls.
    Conclusion
    It seems that workplace hazards play a more significant role than other factors such as air pollution in development of respiratory diseases, and future studies for investigating respiratory symptoms, pulmonary function parameters, biological monitoring and measurement of respiratory hazard need to be performed.
    Keywords: Respiratory symptoms, Shipyard workers, Spirometry
  • Afshin Mohammad Alizadeh, Rehyhaneh Kabiri Movahed*, Mona Mohammadnia Pages 112-116
    Background
    Infectious diseases are a leading cause of morbidity and mortality in developing countries. The aim of this study was to compare the results of blood culture employing the conventional and BACTEC methods for detection of bacterial infection in Taleghani Hospital, Tehran.
    Materials And Methods
    This was a descriptive study carried out for 3 months (March 2014-May 2014) on 272 inpatients. Their blood culture results were analyzed using the two methods (BACTEC and conventional).The results were analyzed using descriptive statistics (frequency, mean and standard deviation) and inferential tests (cross tab) via SPSS version 17 software.
    Results
    The results of 177 cases (94.1%) out of 271 studied subjects were true positive, 11 (5.8%) were false negative, 2 cases (3.15%) were false positive, and 11 cases (6.48%) were true negative. The sensitivity and specificity of the BACTEC test were 84.6 and 94.1, respectively, and the rate of positive blood cultures employing BACTEC method was equal to 100% (22.22) while in the conventional method, positive results were equal to 59.09% (22.13).
    Conclusion
    Both BACTEC and conventional methods have high validity. In order to evaluate the results of blood culture and infection control, experts can use either of these methods to study the results of bacterial blood culture.
    Keywords: BACTEC, Conventional, Hospital, Hospitalized patient
  • Neda Behzadnia, Babak Sharif Kashani, Arda Kiani, Atefe Abedini, Seyed Reza Seyedi *, Hossein Zargham Ahmadi, Farah Naghash Zadeh, Atefeh Fakharian Pages 117-120
    Thrombosis is a life threatening complications of prosthetic mitral valves and is associated with high morbidity and mortality. Even in presence of systemic anticoagulation prosthetic valve thrombosis has an incidence of 0.5% to 8%. Recurrent prosthetic valve thrombosis and the resulting thrombotic occlusion require re-establishment of blood flow across the valve. While surgical repair is considered the classic first line treatment option for prosthetic valve thrombosis, intravenous thrombolysis has emerged as an acceptable alternative for the first episode of prosthetic valve thrombosis. Due to the limitation of using streptokinase in recurrent thrombotic events, fibrin-specific tissue plasminogen activators have been successfully utilized to treat cases of recurrent prosthetic valve thrombosis. In this case-series, we have reported four cases of recurrent prosthetic valve thrombosis that were successfully treated with Reteplase at our hospital.
    Keywords: Prosthetic mitral valve, Complications, Antithrombotic therapy, Reteplase
  • Mohsen Shafipoor, Arda Kiani, Kambiz Sheikhy, Atefeh Abedini, Majid Golestani Eraghi * Pages 121-123
    Echinococcosis or hydatid disease is a helminthic infection caused by larvae of tapeworm Echinococcus granulosus. While the cysts can involve all organs, liver is the most common site of infection and the lungs are the second most commonly involved organ in young adults. In addition to endemic areas its incidence is growing all around the world due to the ease of transcontinental travel. Disease presentation varies and usually is due to mass effect or dysfunction of the involved organ and surgical resection is the recommended treatment. Here we present the case of a young man with primary pulmonary echinococcosis with involvement of the entire right lung.
    Keywords: Echinococcus granulosus, Hydatid cyst, Pulmonary cyst, Surgery