Jundishapur Journal of Chronic Disease Care
Volume:10 Issue: 1, Jan 2021

Air pollution exposure is one of the main risk factors for respiratory system diseases, including airway diseases, Chronic Obstructive Pulmonary Disease (COPD), and lung cancer. Few studies have been done concerning Interstitial Lung Disease (ILD) and its relationship with air pollution. Particulate Matter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), Polyaromatic Hydrocarbons (PAHs), and Heavy Metals (HM) are the most important air pollutants found to exert harmful effects on the human and environment. This review aimed to study the health effects of air pollution on respiratory systems, especially COPD. A narrative review of the literature was done from 1978 to 2020 in various databases, including Google Scholar, Science Direct, Web of Science, Springer, PubMed, NCBI, and BMJ. The results indicated that air pollution exposure could increase respiratory diseases, especially COPD. According to the results, COPD is caused by poor airflow and long-term breathing problems due to disrupted lung tissue. Based on the results, hazardous air pollutants induce destructive effects on the lung and result in COPD. Thus, COPD is a critical public health issue in Iran and the world. To decrease the rate of COPD attributed to air pollutants, we should use policies to decrease pollutant emissions.

 The current study aimed to investigate the effect of fibrinogen compared to fresh frozen plasma (FFP) on outcomes of patients with traumatic hemorrhagic shock (THS).

 In this double-blind RCT study, traumatic hemorrhagic shock patients with chronic diseases referred to the emergency department (ED) were evaluated. Patients were randomly divided into three equal groups; The first group received fibrinogen concentrate (70 mg/kg), the second group was treated with FFP, and the third group received crystalloid. Transfusion of FFP and packed red blood cells (PRBC) was in a 1:1 ratio. The need for admission in intensive care units, PRBC transfusion units, multiple organ failure, hospitalization days, and mortality rate were compared in both groups.

 In total, 45 patients were studied. The number of red blood cells (RBCs) transfused in patients treated with crystalloid, FFP, and Fibrinogen was 2.93, 2.37, and 2, respectively, which was statistically significant (P = 0.03). Two patients (13.3%) in the Fibrinogen-treated group, 4 (26%) in the FFP group, and 2 in the control group had multiple organ failure (P = 0.5). The incidence of sepsis was significantly higher in the FFP-treated group. In addition, mortality was significantly higher in patients who received crystalloid (46.7%) (P = 0.13).

 This study demonstrated that treating patients with fibrinogen concentrate was associated with a decreased number of pRBC transfusion units and mortality. Therefore, management of traumatic patients with fibrinogen concentrate not only can improve the outcomes but also declines patients’ exposure to allogeneic blood products.
 

Context: 

Coronavirus (CoV), as a respiratory-related infectious disease, can be transferred to different animal species subsequently adapted to humans. This virus induces renal disorders such as nephritis. This scoping review investigated the effect of these viruses, especially SARS-CoV-2, in inducing kidney damage and its probable cellular mechanism of action other than the ACE2 receptor.

Evidence Acquisition:

 This scoping review was conducted using Arksey and Omally’s methodology and PRISMA-SCR checklist. To achieve the aim of the study, English articles in the PubMed database were searched until November 2019 by utilization of the MeSH term system, including four groups of search terms of coronavirus, COVID-19, and kidney and in combination with each other.

 After deleting the similar articles (n = 561634), 9,426 of them were selected for the screening and title and abstract review. A total of 75 studies were selected, and 37 remained, 54% of which was between “2010 - 2020” and 46% between “1990 - 2010”, and the study population was 24% human, 31% animal, and 45% cellular. Moreover, 66% of the studies were not cited because of their cellularity and age.

 The present review showed that coronaviruses such as HCv-OC43, HCoV-229E, and TGV induced several kidney injuries, including glomerulonephropathy and proximal tubule destruction through APN expression. Therefore, according to the similar effects of SARS-CoV-2 to other coronaviruses on inducing kidney damages, it could be suggested that this type of coronavirus might produce its pathological effects via the expression of APN in addition to the ACE2 receptor.

 Children with autism spectrum disorders (ASD) suffer from impaired executive functions. Evidence on the effectiveness of two common approaches of ASD (i.e. theory of mind and method of TEACCH) is controversial.

 The current study aimed to investigate the effectiveness of training based on the theory of mind and TEACCHs method on improving the executive functions of children with ASD.

 In this quasi-experimental study with pre-test, post-test method 45 ASD children are investigated. Participants were randomly divided into three groups of the theory of the mind (15), TEACCHs training (15), and controls (15). The Stroop Color and Word Test was performed as a pre-test for all participants. Then the intervention groups received mind theory and TEACCH. Afterward, the post-test was performed for all participants. Data were analyzed using ANCOVA.

 The findings showed that both theory of mind and TEACCHs methods are effective on the executive functions, but no significant difference was found between the two groups of the primary (training the theory of mind) and the second experiments (TEACCHs method) concerning the executive functions (P > 0.157, F = 2.11).

 It can be concluded that training based on the theory of mind and TEACCHs methods can effectively improve the executive functions of ASD children.

 Breast cancer (BC) is one of the most common cancers among women. The survival of the BC patients is based on new treatment protocols. Cardiotoxicity is the most common side effect in these patients.

 This was a descriptive study in which we selected our patients randomly among the BC patients and used questionnaires for data completion.66 BC patients whose disease were confirmed according to the histology and laboratory data taken to the oncology section of Ahvaz Golestan hospital between 2017 - 2018. Risk factors, history of the patients, and the function of the heart were evaluated 6 and 12 months after chemotherapy through echocardiography.

 Six months after chemotherapy, the follow-up patients in 6 indicated five significant risk factor included Age (P < 0.03), history of heart disease (P < 0.02), blood pressure (P < 0.00), diabetes (P < 0.00), and cholesterol (P < 0.04), which confirm the dysregulation function of heart and indication of cardiotoxicity. In 12 months follow- up, the result indicated that only the history of heart disease was significantly correlated with cardiotoxicity (P < 0.01).

 Finally, the detection of risk factors in BC can introduce a prognostic factor when cardiotoxicity occurs simultaneously with the conduction of chemotherapy.

 The hierarchy of power, dynamic of cohesion, and family structure might be affected in families with psychiatric patients.

 This study aimed to compare the power, cohesion, and structure of healthy families and families with psychiatric patients.

 A cross-sectional study was conducted in Shiraz in 2018. Participants were 322 people from healthy families and families with schizophrenic, depressive, or bipolar disordered patients that were compared in terms of cohesion and hierarchy of power. Participants were selected by convenience sampling. Data were collected using the Family System Test, a clinically-derived figure placement technique. Data were analyzed using SPSS-19 with Chi-square and Kruskal Wallis tests at a significance level of less than 0.05.

 There was no significant difference in terms of power between the families of healthy people and the families of patients with psychiatric disorders (P > 0.05). The family of patients with major depression had less cohesion (8.57 ± 2.2) than had the family of healthy ones (P =0.01). The structure of healthy families was more significantly balanced than that of other groups (P = 0.008).

 The results indicated that the power, cohesion, and structure of families can be affected by members with psychiatric disorders. Mental health care providers should take into account the mental health of families of psychiatric patients.

 As the only effective treatment of celiac disease (CD) is a lifelong commitment to a gluten-free diet (GFD), this study was designed to evaluate the efficacy of GFD in the quality of life (QOL) of patients with CD to persuade them for strict commitment.

 In a cross-sectional study, the QOL of CD patients registered in the celiac society of Khuzestan province was evaluated and compared before and at least one year after commencing GFD using the QOL SF-36 questionnaire.

 Overall, 200 CD patients (66 males and 134 females) were evaluated. The average age of male and female participants was 26.3 and 30.34 years, respectively (61% between 20 and 60-years-old). After GFD, complaints such as bloating (P = 0.001), abdominal pain (P = 0.001), diarrhea (P = 0.001), nausea (P = 0.001), vomiting (P = 0.03), reflux and regurgitation (P = 0.025), anorexia (P = 0.001), fatigue (P = 0.001), headache (P = 0.008), oral aphthous lesions (P = 0.014), weight loss (P = 0.001), and bone pain (P = 0.005) significantly improved while other symptoms such as muscular pain (P = 0.157), dermatitis (P = 0.083), and numbness (P = 0.317) did not show any major improvement. The average scores of QOL before and after GFD were 0.74 and 3.41, respectively, which demonstrated significant improvement (P = 0.001). This improvement was even seen among cases with sub-optimal compliance (average QOL score 3.28, P = 0.001).

 A gluten-free diet could significantly improve the quality of life of patients with celiac disease, and they should be encouraged as much as possible to be committed to this regimen.

 Diabetes is a highly prevalent metabolic disorder in the world. Complications of diabetes mellitus can have an extreme effect on the quality of life in terms of physical and mental health, as well as social and environmental well-being.

 The current study aimed to measure the quality of life, its determinants, and self-care behaviors in patients with type 2 diabetes.

 A descriptive cross-sectional study was conducted in the diabetes clinic of Imam Reza hospital in Mashhad on 140 patients with type 2 diabetes from October to December 2019. The Summary of Diabetes Self-care Activities (SDSCA) questionnaire and the World Health Organization Quality of Life-Brief (WHOQOL-BREF-26 items) were used for data collection. Data analysis was carried out with the Mann-Whitney test and ANCOVA.

 The mean age of study participants was 58.41 ± 8.91 years, and the majority of them (67.14%) were female. The overall self-care score was 43.32 ± 10.93 in males and 39.93 ± 9.94 in females. The mean scores of the dimensions of quality of life were 61.29 ± 15.66 for physical health, 60.62 ± 13.70 for mental health, 68.67 ± 11.63 for social health, and 61.54 ± 14.88 for environmental health. Among self-care behaviors, physical activity (P = 0.006) was a stronger predictor of quality of life. Demographic characteristics (except for the duration of disease, family history, and age) showed significant correlations with the overall aspects of quality of life.

 The quality of life of people with diabetes was correlated with some demographic variables. However, the duration of disease, family history, and age did not have any effect on the quality of life. We found that the self-care behavior of physical activity was a significant predictor of quality of life in adults with diabetes. Therefore, it is important to implement programs to improve self-care behaviors.

 Beta-thalassemia is one of the most important health problems worldwide. Identifying common mutations as well as the relationship between serum ferritin level and gene mutations in patients with intermediate and major thalassemia can be helpful in preventive programs.

 The purpose of this study was to assess the association between serum ferritin level and gene mutations in patients with intermediate and major thalassemia.

 This descriptive cross-sectional study was done using patients' medical records available in the hospital archives, and data of 132 patients with mutated genes referred to Ahvaz Shafa hospital from 2012-2017 were evaluated. In addition to determining the frequency of different gene mutations, the relationship between different gene mutations and serum ferritin levels, as well as hemoglobin levels before the first blood transfusion and the age of the patients (month) before the first blood transfusion, were investigated.

 There was no significant relationship between mutated genes and serum ferritin levels (P = 0.2). There was a significant difference between the types of gene mutations and the levels of hemoglobin before the first blood transfusion (P = 0.01). There was no significant difference between the types of gene mutations and the age of the patients before the first blood transfusion (P = 0.4).

 There was no association between the types of mutations and serum ferritin levels as an indicator of disease severity. Patients with hemoglobin levels of 6 to 7 mg/dl were found with a higher likelihood of receiving a blood transfusion, with a higher percentage having the IVSII-I gene mutation, but given that many mutations were random and we just had one or two patients with these mutations, it cannot be used as an indicator for disease severity. We need to conduct studies with a larger sample size to be used as an indicator for disease severity. Since the influence of the other accompanying genes and polymorphism plays an important role in the clinical manifestations of genetic diseases, it can be the reason for some negative results.