فهرست مطالب

Tanaffos Respiration Journal
Volume:17 Issue: 1, Winter 2018

  • تاریخ انتشار: 1397/09/12
  • تعداد عناوین: 10
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  • Samane Hoseini, Shahrestanak, Nasrin Bazargan, Leila Rahimian, Maryam Nemati, Saeed Solaymani, Abdollah Jafarzadeh Pages 1-12
    Background
    The imbalance between Th2 and Treg cells plays fundamental role in the pathogenesis of allergic asthma. The current study aimed at assessing the expression of some Th2 and Treg cell-related parameters in patients with allergic asthma. Material and
    Methods
    The serum and peripheral blood mononuclear cell (PBMC) samples were collected from 30 patients with asthma and 36 healthy subjects. The serum levels of transforming growth factor (TGF)-β,‎ interleukin (IL)-4, as well as the expression levels of GATA3 and FOXP3 genes in PBMCs were determined by the enzyme-linked immunosorbent assay (ELISA) and real-time polymerase chain reaction (PCR), respectively. The PBMCs were cultured for 48 hours with/without phytohemagglutinin (PHA) stimulation. The TGF-β‎ and IL-4 levels in supernatants were also determined.
    Results
    The serum levels of IL-4, the expression level of GATA3, and GATA3/FOXP3 ratio in patients with asthma were significantly higher than healthy subjects (P <0.002, P <0.001, and P <0.004, respectively). The FOXP3 expression did no differ between the two groups. The serum level of TGF-β‎ as well as its secretion profile in non-stimulated and stimulated PBMCs isolated from patients with asthma were significantly higher than those of the controls (P <0.03, P <0.001, and P <0.001, respectively). The serum TGF-β levels in severe asthma were significantly higher than moderate asthma; whereas the TGF-β ‎secretion by PHA-stimulated PBMCs isolated from moderate asthma was higher than that of severe pattern of the disease (P <0.001 and P <0.05, respectively). The GTAT3/FOXP3 expression ratio in moderate asthma was significantly higher than severe form (P <0.04).
    Conclusion
    The results confirmed a Th2 cell-biased pattern and possible contribution of TGF-β in allergic asthma. TGF-β may have different expression patterns in moderate and severe asthma and the two forms of the disease may have differences in some main immunological parameters
    Keywords: Allergic Asthma, Th2, Treg, Transcription Factors, GATA3, FOXP3
  • Jingxi Zhang, Chong Bai Pages 13-21
    Backgrounds
    Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is closely related to disease mortality. Systemic inflammation is considered to be involved in the pathogenesis of AECOPD. The current study aimed to investigate the clinical significance of the classic chemokine interleukin (IL)-8 in serum during AECOPD.
    Materials and Methods
    In this current cross sectional, observational study, 50 patients with AECOPD, 25 patients with stable COPD and 25 healthy nonsmokers as the control group were selected. Clinical characteristics and spirometry data were collected. All patients were classified as grade 1-4 based on forced expiratory volume in 1 second (FEV1) after bronchodilation according to the GOLD severity classification and were divided into frequent exacerbation (FE) group (≥2 times/year) and non-frequent exacerbation (NFE) group (<1 time/year) according to acute exacerbation (AE) times in the previous 12 months before the visit. The serum IL-8, IL-6, tumor necrosis factor (TNF)-α, and superoxide dismutase levels were measured by the enzyme-linked immunosorbent assay technique.
    Results
    Serum IL-8 levels increased sequentially from controls [9.45 pg/mL (ranged: 6.85-38.4)], to stable [51.60 pg/mL (ranged: 22.4-131.1)], and exacerbation stage [129 pg/mL (ranged: 57.7-374)]. The level of serum IL-8 was significant higher in patients with FE than that of patients with NFE (209.0 pg/mL (ranged: 115-472) vs 65.6 pg/mL (ranged: 11.2-149.3), P=0.008). A receiver operating characteristics curve (ROC) generated to evaluate IL-8, IL-6, and TNF-α levels to discriminate between patients with and without exacerbation showed that the total area under the curve (AUC) was 0.71 (95% confidence interval (CI): 0.5764-0.8381; P=0.003), 0.54 (95%CI: 0.4048-0.6943; P=0.54), and 0.52 (95%CI: 0.3912-0.6656; P= 0.7).
    Conclusion
    Serum IL-8 is a sensitive, easy-to-measure, and inexpensive biomarker to give an indication of the course of COPD during exacerbation, and is a target to be explored further as a predictor to distinguish the patients prone to exacerbation
    Keywords: Exacerbation, Chronic Obstructive Pulmonary Disease, Interleukin 8, Interleukin 6, Tumor Necrosis Factor-?
  • Hooshang Akbari, Ebrahim Nasiri, Attieh Nikkhah, Seyed Hossein Ardehali Pages 22-28
    Background
    Propofol is one of the most frequently used medications for inducing and maintaining anesthesia. However, propofol injection causes pain and discomfort in more than 70% of patients. This study was performed to determine the comparative effects of ketamine, sodium-thiopental, and magnesium sulfate on reducing pain at the onset of anesthesia induced by propofol injection.
    Materials and Methods
    This single-blind randomized clinical trial was conducted on a population of patients, requiring nonemergency surgeries. The sample size was determined as 25 patients per group. The eligible samples were randomly divided into three groups. An 18-gauge intravenous catheter was inserted in the dorsum of the hand for all patients. Three groups received 0.5 ml/kg of ketamine, 30 mg/kg of magnesium sulfate, and 0.5 ml/kg of sodium-thiopental, respectively. Next, 2.5 mg/kg of propofol 2% was administered at a rate of 1 ml/s. The verbal rating scale (VRS) was applied to assess the severity of pain during injection.
    Results
    According to the results, the prevalence of pain was 36% in the magnesium sulfate group, 16% in the sodium-thiopental group, and 4% in the ketamine group. The ordinal logistic regression test showed that patients from the ketamine group experienced less pain, compared to the magnesium sulfate group (OR, 0.045; P= 0.008). However, no significant difference was observed between the ketamine and sodium-thiopental groups (OR, 0.253; P= 0.283).
    Conclusion
    Ketamine and sodium-thiopental can be effective medications in reducing pain caused by propofol injection. According to the results, magnesium sulfate is not recommended for reducing pain due to propofol injection.
    Keywords: Ketamine, Magnesium sulfate, Sodium-thiopental, Propofol, Injection, Pain, Analgesic
  • Nooredin Mohammadi, Ali Pooria, Sajad Yarahmadi, Mohammad Javad Tarrahi, Hassan Najafizadeh, Payam Abbasi, Behzad Moradi Pages 29-36
    Background
    Chest tube removal is considered a painful technique, which may not respond well to palliative therapies. There are no standard procedures or guidelines to manage the pain associated with chest tube removal. This study aimed to examine the effects of cold application on pain reduction during and after chest tube removal.
    Materials and Methods
    This randomized controlled trial was conducted on 90 hospitalized patients, undergoing heart bypass surgery at the intensive care units where at least a pleural chest tube was inserted. The patients were randomly divided into two groups (45 samples per group). In the cold application group, an ice bag was placed at the designated point for 20 minutes before chest tube removal, while only routine interventions were applied for chest tube removal in the control group. Pain severity was measured in the groups before, during, and 15 minutes after chest tube removal, using the visual analogue scale. Repeated measures ANOVA test was applied for data analysis.
    Results
    There was no significant difference in the baseline pain score between the groups (P= 0.18). However, there was a significant difference in terms of pain severity score between the cold application (3.58±1.09) and control (4.73±0.86) groups during chest tube removal (P< 0.001). On the other hand, there was no significant difference between the groups regarding the score of pain severity at 15 minutes after chest tube removal (P= 0.38).
    Conclusion
    Cold application, as a nonpharmacological intervention, may contribute to the alleviation of cryotherapy-related pain
    Keywords: Chest tube, Cryotherapy, Pain, Visual analog scale
  • Maryam Hassanzad, Shabnam Eslampanah, Mohammadreza Modaresi, Sabereh Tashayoie, Nejad, Ali Akbar Velayati Pages 37-41
    Background
    Smoking is a known predisposing factor to exacerbations in CF patients. But the effects of second-hand tobacco smoking are not yet clear. Hence, this study determined the clinical and spirometric presentations and urinary cotinine levels among cystic fibrosis patients over seven years of age in relation to their parent’s smoking history.
    Materials and Methods
    In this cross-sectional comparative study, 58 consecutive cystic fibrosis patients older than seven years of age were enrolled. These patients were divided into two equal groups: those with second-hand tobacco smoking and those without. Pulmonary function tests and hospital admission rates were compared across the groups.
    Results
    The mean hospital admission times were 5.1±2.4 in the group with passive smoking, and 2.6±1.3 times in the group without (P<0.001). The cotinine level was reversely correlated to time interval passed from previous admissions (P=0.001, r=–0.432) in passive smokers and (P=0.021, r=0.314) in non-passive smokers. In the analysis of FEV1 with urine, there was a significant but negative relation between FEV1 and cotinine (P= 0.002). Besides, in the analysis of FE25-75 and urine cotinine, there was also a significant and negative relationship (P=0.001).
    Conclusion
    From our findings, we conclude that pulmonary function tests and hospital admission rate in patients with cystic fibrosis are associated with urinary cotinine level and household second-hand tobacco smoking
    Keywords: Pulmonary function test, Cystic fibrosis, Second-hand smoking
  • Mohammad Hassan Nassiri, Kashani, Mashallah Aghilinejad, Amir Bahrami, Ahmadi, Omid Moslemi, Elahe kabir, Mokamelkhah Pages 42-46
    Background
    Workers in dairy products companies are exposed to different respiratory hazards. The current study aimed at investigating and comparing the prevalence of pulmonary function parameters, signs, and symptoms in the exposed workers and office staff.
    Materials and Methods
    The current cross sectional study was conducted in 2015 on 864 employees working in a dairy products company in Tehran, Iran. The subjects included 646 employees exposed to respiratory hazards at the production line and the other group consisted of 218 staff not exposed to respiratory hazards in the production line as the unexposed group. Demographic characteristics and the presence of respiratory symptoms and signs were gathered using a checklist. Spirometric indices including FEV1, forced volume vital capacity (FVC), and FEV1/FVC were measured for the study participants.
    Results
    Although exposure to the respiratory hazards among participants of the exposed group was lower than permitted limits, the frequency of respiratory signs and symptoms were significantly higher than those of the unexposed staff. In the current study, mean percentage of FVC, FEV1/FVC, and FEV1 were significantly less than the predicted amount in the exposed group than in the unexposed group.
    Conclusion
    Although the frequency of respiratory signs and symptoms was lower than those of other similar studies, abnormal spirometric patterns were common; hence, it can be pointed out that even in the work environments, such as dairy products industry with below the permissible exposure limit of respiratory risks, multiple spirometric disorders can be observed. In other words, the absence of respiratory signs and symptoms are insufficient and application of different pulmonary function tests, such as spirometry, seem essential for assessment.
    Keywords: Dairy Companies, Respiratory Symptoms, Spirometry
  • Zahra Kashaninia, Zahra Payrovee, Reza Soltani, Seyed Alireza Mahdaviani Pages 47-52
    Background
    Recent surveys have showed that asthma control still remains suboptimal. Family members have an extensive impact on the level of asthma control in school-age children. Family empowerment has a positive impact on the quality of life of school-age children with asthma. This study aimed to determine the efficacy of family empowerment on asthma control in school-age children.
    Materials and Methods
    Forty-five children with asthma (6–12 years) and their parents were enrolled in a pediatric asthma clinic during their follow-up visits. The family empowerment program consisted of self-directed educational material, lectures (a nurse-focused format), group interaction (a learner-focused format), group discussions, and demonstration of educational films. The primary outcome was change in asthma control measured by the C-ACT questionnaire.
    Results
    In this study, 45 patients were enrolled and randomly divided into two groups: intervention (n=23) and control (n=22). Demographic variables including age and sex were not significantly different between the two groups. There were no significant differences in pre-test asthma control scores between the intervention and control groups at pre-test (p=0.82). However, there was a significant difference in asthma control scores between the intervention and control groups at post-test (p<0.001). In the intervention group, in which children experienced family empowerment, asthma control scores were significantly higher at post-test compared to pre-test (p<0.001).
    Conclusion
    Family empowerment significantly improved asthma control in school-age pediatric patients. This program could be proposed for proper asthma control and complication-reducing management of the disease. This program is recommended more broadly for other age groups
    Keywords: School-age children, asthma, family empowerment, control
  • Hassan Ghobadi, Zahra Amirajam, Afshin Habibzadeh Pages 53-56
    Massive pulmonary thromboembolism (PTE) has an increased risk of mortality. Thrombolytic therapy is the accepted treatment. Reteplase, a variant of tissue plasminogen activator, has been used in acute myocardial infarction with acceptable safety and efficacy, but studies in massive PTE are rare. In this study we report five cases of successful treatment of massive PTE with reteplase.
    Keywords: Pulmonary Thromboembolism, Reteplase, Bleeding
  • Fatemeh Roodneshin, Mahtab Poor Zamany Nejat Kermany, Pooya Rostami, Hamed Tanghatari Pages 57-61
    Sturge-Weber syndrome (SWS) is a neurocutaneous disorder, characterized by leptomeningeal angiomas involving the oral cavity, trachea, larynx, and face. Herein, we present a case of vitrectomy in a seven-year-old boy with SWS. The patient showed hemangioma on the left side of his face, as well as mental retardation and epilepsy. Preoperative examination revealed no apparent hemangioma in the oral cavity, pharynx, larynx, or trachea. However, he was predicted to have difficult airway intubation, as the oral cavity was smaller than the normal size. The minimum Mallampati score was 3-4 due to macroglossia. First, we applied awake intubation, but he failed to follow the commands. We proceeded to general anesthesia with propofol and did not use any muscle relaxants to maintain spontaneous breathing. A laryngeal mask airway was inserted to minimize any harm to possible oral angiomas. The patient was hemodynamically stable and extubated without any complications, such as bleeding or respiratory problems.
    Keywords: Sturge-Weber syndrome, Propofol, Difficult airway
  • Mohsen Shafiepour, Arda Kiani, Kimia Taghavi, Sharareh Seifi, Mitra Sadat Rezaie, Seyed Mohammad Reza Hashemian, Atefeh Abedini Pages 62-65
    Basal cell carcinoma is a common non-melanotic skin cancer with a prevalence of 74.5%–82.6% in the Iranian population. BCC rarely metastasizes. However, metastasis can cause significant morbidity. The prevalence of metastatic basal cell carcinoma varies between 0.0028% and 0.55% of all cases. We describe a case of lung metastasis of basal cell carcinoma of the scalp
    Keywords: Basal cell carcinoma, Pulmonary, Lung metastasis, Metastatic basal cell carcinoma