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Tanaffos Respiration Journal - Volume:16 Issue: 4, Autumn 2017

Tanaffos Respiration Journal
Volume:16 Issue: 4, Autumn 2017

  • تاریخ انتشار: 1396/10/30
  • تعداد عناوین: 9
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  • Kamran Bagheri Lankarani, Behnam Honarvar, Seyyed Shamsadin Athari * Page 251
    Helicobacter pylori, a gram negative pathogen, infects the stomach and gastrointestinal tract and causes pathological damage to these organs. H. pylori infection is more prevalent among people living in developing countries. Allergic asthma is a chronic inflammatory disease of the airways. Hyperinflation, hyperresponsiveness, and abnormal immunological and inflammatory processes in respiratory airways typically occur during an asthma attack. The results of recent studies have suggested an association between H. pylori and asthma risk. However, the role of H. pylori infection in the pathophysiology of asthma is still a matter of debate. The results of some studies indicate an association between H. pylori infection and protection against allergic asthma. Exposure to infectious agents might educate the immune system and provide protection against allergic diseases. H. pylori inflammation also changes gastric hormonal levels and could influence the autonomic nervous system. T-regs could be influenced by the immunological response to H. pylori and then inhibit the Th-2-mediated allergic response. Therefore, H. pylori might play a protective role against asthma. H. pylori can also reduce gastro-esophageal reflux, which is an asthma stimulator. High loads of H. pylori are not always present during infection. It is not definitely clear whether H. pylori is a pathogen or simply an opportunist. It has been suggested that early exposure to H. pylori prevents development of pediatric asthma. Therefore, it is possible that therapeutic products made from H. pylori can be used for the treatment or prevention of asthma.
    Keywords: Helicobacter pylori, Allergic Asthma, Protection
  • Jingxi Zhang *, Chong Bai Page 260
    Background
    To explore the clinical significance of serum interleukin-8 (IL-8) level as a biomarker for uncontrolled asthma in order to improve our understanding of asthma phenotypes and facilitate the development of new therapeutic agents in the future.
    Materials And Methods
    A total of 246 uncontrolled asthma patients and 50 healthy controls were selected from an outpatient clinic during October 2015 and April 2016. The clinical data were collected, and the levels of IL-8, IL-6, tumor necrosis factor-α (TNF-α), and immunoglobulin (IgE) were measured in peripheral blood via ELISA assay. The level of serum IL-8 was compared between the glucocorticosteroid groups, receiving inhaled corticosteroids (ICs), oral corticosteroids (OCs), and intravenous corticosteroids (GCs), respectively. Changes in the serum IL-8 level were compared between asthmatics with good and poor glucocorticosteroid responsiveness.
    Results
    The serum IL-8 level in uncontrolled asthmatics (87.45 pg/mL; 5-7500) was significantly higher than that of the healthy controls (10.9 pg/mL; 6.8-39.65; P
    Conclusion
    The increase in serum IL-8 level can be used as a preferable biomarker to identify asthma status and initial treatment in asthmatics. The change in IL-8 level also reflects the response to glucocorticosteroids in uncontrolled asthma. These exploratory results suggest an association between the pathophysiology, inflammation, and clinical outcomes of asthma. This raises the possibility of developing new agents for IL-8 inhibition and helps provide more precise and personalized asthma care.
    Keywords: Uncontrolled asthma, Interleukin, 8, Fractional exhaled nitrite oxide, Biomarker
  • Jamshid Yazdani- Charati, Behzad Mahaki, Elham Ahmadi-Basiri * Page 270
    Background
    Nowadays, tuberculosis (TB)–an infectious disease caused by Mycobacterium tuberculosis–presents with different location patterns. Spatial analysis is one of the most important tools to detect and monitor public health disease patterns. This study aimed to identify the low and high-risk areas in Lorestan Province (west of Iran) to help the health programmer for the best intervention.
    Materials And Methods
    Lorestan has 9 counties, 22 cities, 25 zones, 81 villages, and 2842 residential villages. Our study cases were 1481 patients registered in the TB center of Lorestan Province. We investigated the spatial distribution of TB in Lorestan between 2002 and 2008 using a multilevel model. STATA Ver. 10 software was used for the data analysis.
    Results
    The multilevel model was a better fit to the data for the spatial correlation structure. It adjusted relative risks by borrowing information of the neighboring areas in each village. Maximum risk of disease was seen in the central zone of Koram-Abad, and all villages of Delphan were identified as low-risk areas.
    Conclusion
    Various factors such as improvement of socio-economic conditions, implementation of programs, culture, genetic background, health-related behavior, and lifestyle can influence TB control substantially. A deprived region located in the southern part of Khoram-Abad was identified as the highest risk area in our study. The poor socio-economic structure can be an important factor for the increased risk of TB in this region.
    Keywords: Tuberculosis, Spatial pattern, Relative Risks, Lorestan province, Multilevel modeling
  • Bita Najafian, Mohammad Torkaman, Ehsan Shahverdi *, Reza Noroozian Page 277
    Background
    Ventilator-associated pneumonia (VAP) is the second most common nosocomial infection in neonates, admitted to neonatal intensive care units (NICUs). The aim of this study was to identify the main causes of bacterial colonization in endotracheal tubes and tracheal secretions of neonates hospitalized in the NICUs of our university hospitals.
    Materials And Methods
    This cross sectional study was conducted during 2015-2016. Thirty-nine neonates, who were under mechanical ventilation in the NICUs of Baqiyatallah and Najmiyeh hospitals of Tehran, Iran, were assessed. The patients were selected using the census sampling method. Gestational age, birth weight, duration of mechanical ventilation, length of hospital stay, tracheal discharge culture, endotracheal tube culture, blood culture, and chest radiography were evaluated.
    Results
    In a total of 39 neonates (50.3% males and 49.7% females) with the mean age of 1.17±1.12 days, bacterial growth was reported in 6 (15.3%) cases. The antibiotic study of tracheal secretion and endotracheal tube cultures showed that 2.6% of patients were resistant to cephalosporins, aminoglycosides, nitrofurantoin, and carbapenem. Moreover, 12.8% were also resistant to fluoroquinolones, besides these antibiotics.
    Conclusion
    Tracheal secretion culture is a simple and proper approach for the diagnosis of VAP. Besides reducing the costs, this method can play a significant role in decreasing the incidence of infections.
    Keywords: Ventilator, associated pneumonia, Neonatal intensive care unit, Trachea, Culture, Antibiotics
  • Seyyed Reza Seyyedi, Majid Malekmohammad, Mandana Chitsazan, Neda Behzadnia, Makan Sadr *, Seyed Mohammadreza Hashemian, Babak Sharif-Kashani Page 283
    Background
    Right heart catheterization is the gold standard test for diagnosis and clinical assessment of the patients with pulmonary hypertension (PH). In recent years, the usefulness of cheaper and non-invasive tests in the follow-up of PH patients is being studied. The aim of the present study was to evaluate the relationship between serum uric acid level and severity of pulmonary hypertension in PH patients.
    Materials And Methods
    In a cross-sectional study, serum uric acid was measured in 110 patients with PH (63 women; mean age [±SD] was 52.83±17.88 years). Pulmonary arterial pressure and severity of right ventricular dysfunction were assessed using RHC and echocardiography, respectively.
    Results
    Serum uric acid was higher in PH patients with severe RV dysfunction, compared to mild and moderate dysfunction (7.8mg/dl [IQR: 5.8-9.2] in severe dysfunction, versus 4.7 mg/dl [3.87-5.82] in mild dysfunction and 5 mg/dl [3.5-6.95] in moderate dysfunction. Serum uric acid was significantly correlated with pulmonary artery systolic pressure (r=0.51, P
    Conclusion
    Serum uric acid is correlated with the severity of symptoms and RV dysfunction in patients with pulmonary hypertension. Further studies are recommended with larger sample size in this regard.
    Keywords: Uric acid, Severity, Pulmonary hypertension
  • Alireza Mahdavi, Seyed Sajad Razavi, Bita Malekianzadeh, Afsaneh Sadeghi * Page 289
    Background
    The present study was performed with the aim of comparing the peak inspiratory pressure and lung dynamic compliance between a classic laryngeal mask airway (LMA) and an endotracheal tube in children under mechanical ventilation.
    Materials And Methods
    In this study, 30 children aged 1 to 7 years with a physical condition of ASA I–II who were admitted for operations to repair inguinal hernias, hydroceles, or hypospadias were randomly enrolled. After induction of anesthesia, the appropriate laryngeal mask was used for each patient and they were placed under pressure-controlled mechanical ventilation. The peak inspiratory pressure was adjusted and recorded to obtain an appropriate tidal volume, then the laryngeal mask was removed and the appropriate size uncuffed endotracheal tube was inserted and the patient was placed again under controlled mechanical ventilation. The required settings were adjusted and peak inspiratory pressure and tidal volume were measured and recorded by the ventilator. Dynamic compliance was also calculated in both cases using the appropriate formula.
    Results
    The results showed that peak inspiratory pressure (PIP) with the use of LMA in children under mechanical ventilation was less than the PIP with the use of an endotracheal tube (p0.05). Also, the pulmonary dynamic compliance with a laryngeal mask was greater than the use of an endotracheal tube (p0.05).
    Conclusion
    A laryngeal mask airway due to its low airway resistance and high dynamic compliance is an acceptable alternative to a tracheal tube during mechanical ventilation and it can be a good alternative to the endotracheal tube, especially during mechanical ventilation of children, in whom avoidance of barotrauma is desirable.
    Keywords: Dynamic compliance, Inspiratory pressure, Endotracheal tube, Classical laryngeal mask airway
  • Elahe Tavakol, Mansour Azari *, Rezvan Zendehdel, Sousan Salehpour, Soheila Khodakrim, Saeed Nikoo, Behzad Saranjam Page 295
    Background
    Aerosols generated during construction activities are an integral part of building operations. Considering the nature of materials used in construction activities,respirable dust contains crystalline silica and particulates not otherwise specified (PNOS). Due to lack of data regarding the occupational health status of Iranian construction workers,the objective of this study was to evaluate occupational exposure to silica and to examine their respiratory health status.
    Materials And Methods
    In this cross sectional study,85 construction workers and 40 controls (without active exposure to construction dust) were studied. The workers exposure to PNOS and silica aerosols was monitored by the NIOSH method No.0600 and a new Fourier transform infrared spectroscopy (FTIR)-based method,respectively. All subjects were also monitored for lung function parameters,such as forced expiratory volume/forced vital capacity (FEV1/FVC),peak expiratory flow rate (PEFR),forced expiratory flow (FEF25-75),FVC,and FEV1.
    Results
    The mean exposure of workers to respirable PNOS and silica was 9.8 (0.35) and 0.13 (0.019) mg/m3,respectively. The groups of construction workers showed significant differences in exposure to PNOS (P
    Conclusion
    Considering the construction workers excessive exposure to PNOS and silica,besides depressed lung function parameters,they can be classified as a high-risk group for respiratory diseases.
    Keywords: Construction, Crystalline silica, PNOS, Respiratory system
  • Arda Kiani, Kimia Taghavi, Hadi Rokni-Yazdi, Atefeh Abedini * Page 304
    Pulmonary metastases occasionally do not respond to chemotherapy and surgery. Moreover, some early stage cancer patients, who are candidates for surgery, are unable to tolerate surgery. In such cases, microwave ablation is a convenient alternative for tumor eradication. Microwave ablation has low morbidity and mortality rates compared to traditional cancer treatments. Moreover, the lower procedural cost, potential to perform treatment in an outpatient setting, and repeatability are beneficial aspects of this technique. Herein, we report an adenocarcinoma case that was potentially unsuitable for surgery and was treated with percutaneous microwave pulmonary tumor ablation in August 2015 at the Bronchoscopy and Laser ward of the Shahid Beheshti Medical University, Iran.
    Keywords: Microwave tumor ablation, Adenocarcinoma, Microwave
  • Ramin Sami *, Sara Aeini, Raheleh Sadegh Page 309
    Herpetic pneumonia in immune deficient patients could be fatal if not treated. Considering the low prevalence of this disease, computed tomography (CT) scan findings of this condition are not well elucidated. This report describes the CT scan findings of a patient with immune system deficiency due to mycosis fungoides, and pneumonia caused by herpes simplex virus 1 (HSV-1). Bilateral alveolar infiltration with crazy-paving pattern was observed on CT scan of the lungs. The scattered crazy-paving pattern noted in the CT scan of the lungs could be suggestive of herpetic pneumonia in immunocompromised patients presenting with lung infections.
    Keywords: Herpes simplex virus 1, Pneumonia, Mycosis Fungoides