ORIGINAL_ARTICLE
Risk Factors of Unplanned Extubation in Pediatric Intensive Care Unit
Background: Unplanned extubation (UE) is an unprecedented happening in pediatric intensive care unit (PICU); which may lead to severe complications in patients. The risk factors of UE have been discussed but much details are still required in this regard. This study aimed to evaluate predisposing and risk factors of unplanned extubation in PICU. Materials and Methods: Patients intubated in PICU who had UE were compared to a control group without UE in a retrospective study. Fifty-nine patients with UE matched with 180 controls were enrolled. Factors including age, gender, use of cuffed endotracheal tube (ETT), duration of intubation, patient agitation, and ETT fixation method were analyzed. Results: A total of 59 UEs occurred in 239 intubated patients in a total of 1631 intubated patient-day. This represents UE incidence rate of 1.95% per patientday and 3.6% per intubated patient-day. In multivariate analysis, risk factors for UE included age younger than 2 years (OR: 1.34, 95% CI: 1.13-3.61, P=0.001), male gender (OR: 2.53, 95% CI: 1.35-4.23, P=0.005), agitation (OR: 1.83, 95% CI: 1.54-5.36, P=0.001), high saliva secretion (OR: 4.42, 95% CI: 2.35-5.45, P=0.007), and duration of intubation (OR 1.39, 95% CI: 1.22-2.58, P=0.01). Conclusion: Unplanned extubation can be a catastrophic incident if enough attention is not paid to the patients at risk in PICU. These risk factors are age younger than 2, male gender, agitation, high salivary secretion and duration of intubation.
https://www.tanaffosjournal.ir/article_241007_0906cc2fb9912d9267e77cbe5d2de05e.pdf
2013-10-01
11
16
Unplanned extubation
Pediatric ICU
Risk Factors
Incidence
Mortality
Seyed Sajad
Razavi
1
Department of Anesthesiology, Mofid Pediatric Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
LEAD_AUTHOR
Reza
Amin Nejad
2
Department of Anesthesiology, Mofid Pediatric Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
AUTHOR
Seyed Amir
Mohajerani
3
Department of Anesthesiology, Mofid Pediatric Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
AUTHOR
Mahshid
Talebian
4
Department of Anesthesiology, Mofid Pediatric Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
AUTHOR
ORIGINAL_ARTICLE
Knowledge and Practice of Asthmatic Children’s Parents About Daily Air Quality
Background: Knowledge and practice about air pollution are essential subjects in special groups such as cardio-pulmonary patients. For children with air pollution-related diseases, knowledge and attitude of parents play a determining role in this respect. Since providing a coherent curriculum needs evidence-based information, this survey was conducted to assess the knowledge and practice of asthmatic children’s parents about daily air quality since asthmatic children are among the most vulnerable at-risk groups when it comes to air pollution. Materials and Methods: All parents of asthmatic children referred to the Pediatric Clinic of Masih Daneshvari Hospital during one year period (250 people) completed knowledge and practice questionnaire on air pollution. Knowledge questions consisted of familiarity with pollution standard index (PSI), ways to find out about it, respiratory effects of air pollution and etc. Practice questions consisted of reducing outdoor presence and activity of children and actions taken to reduce air pollution in polluted days. Results: In general, 3.2% of parents were familiar with PSI, 12.5% were aware of ways to find out about daily air quality, 65.2% were aware of air pollution respiratory effects, 65.6% were aware of air pollution effects on asthmatic children and 4.4% were aware of ineffectiveness of surgical masks in prevention of air pollution health effects. The obtained practice score ranged from 4 to 16, and the participants’ mean score was equal to 11.79. Conclusion: This study revealed that parents of asthmatic children were aware of air pollution hazards for their children and wanted to prevent them but they did not know how. Therefore, asthmatic children in Tehran are still exposed to risks of air pollution.
https://www.tanaffosjournal.ir/article_241009_e98e736a155910a1ae268f0b9126f2a4.pdf
2013-10-01
23
28
Knowledge
Practice
Air pollution
Asthmatic children
Parents
Taraneh
Yazdanparast
1
Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD) Shahid Beheshti University of Medical Sciences, Tehran, Iran,
AUTHOR
Seyed Mohammad
Seyedmehdi
2
Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD) Shahid Beheshti University of Medical Sciences, Tehran, Iran,
AUTHOR
Soheila
Khalilzadeh
3
Pediatric Respiratory Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
AUTHOR
Sousan
Salehpour
4
Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD) Shahid Beheshti University of Medical Sciences, Tehran, Iran,
AUTHOR
Mohammad Reza
Boloursaz
5
Pediatric Respiratory Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
AUTHOR
Nooshin
Baghaie
6
Pediatric Respiratory Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
AUTHOR
Maryam
Hassanzad
7
Pediatric Respiratory Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
LEAD_AUTHOR
Ali Akbar
Velayati
8
Clinical Tuberculosis and Epidemiology Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
AUTHOR
ORIGINAL_ARTICLE
The Effect of High Intensity Interval Exercise in High / Low Temperatures on Exercise-Induced Bronchoconstriction (EIB) in Trained Adolescent Males
Background: Exercise-induced bronchoconstriction (EIB) describes airway narrowing that occurs in association with exercise. Exercise in hot and cold environments has been reported to increase exercise-induced bronchoconstriction (EIB) in subjects with asthma. However, to our knowledge, the effect of hot and cold environment on pulmonary function and EIB in trained males has not been previously studied. The main goal of this research was to examine the influence of environmental temperature and high intensity interval exercise on pulmonary function in trained teenage males. Also, this study sought to assess the influence of exercise and environmental temperature on EIB. Materials and Methods: Thirty trained subjects (mean age 16.56±0.89 yrs, all males) underwent high intensity interval exercise testing (22 minutes) by running on a treadmill in hot and cold environments under standardized conditions (10 ºC and 45 ºC with almost 50% relative humidity in random order in winter and summer). Lung function (flow volume loops) was measured before and 1, 5, 15, 30 and 60 min after the exercise by digital spirometer. Data was analyzed using SPSS software and p
https://www.tanaffosjournal.ir/article_241010_9d9e257fb8826034c7e5ea483aa45c9b.pdf
2013-10-01
29
43
Temperature
Exercise-Induced Bronchoconstriction
Exercise
Mahmoud Asle
Mohammadizadeh
1
Department of Sport Physiology , School of Physical Education & Sport Sciences , Shahid Chamran University of Ahvaz - IRAN
LEAD_AUTHOR
Mohsen
Ghanbarzadeh
2
Department of Sport Physiology , School of Physical Education & Sport Sciences , Shahid Chamran University of Ahvaz - IRAN
AUTHOR
Abdolhamid
Habibi
3
Department of Sport Physiology , School of Physical Education & Sport Sciences , Shahid Chamran University of Ahvaz - IRAN
AUTHOR
Saeed
Shakeryan
4
Department of Sport Physiology , School of Physical Education & Sport Sciences , Shahid Chamran University of Ahvaz - IRAN
AUTHOR
Masoud
Nikbakht
5
Department of Sport Physiology , School of Physical Education & Sport Sciences , Shahid Chamran University of Ahvaz - IRAN
AUTHOR
ORIGINAL_ARTICLE
Correlation between hs-CRP and Asthma Control Indices
Background: Local and systemic inflammation occur at the same time in asthma and high sensitive CRP may play a role in the pathogenesis of this disease. Conventional approaches to monitor and control asthma involve no direct assessment of airway inflammation. There are some recent data postulating a discrepancy between the markers of airway and systemic inflammation and asthma control test (ACT) scores. In this study we evaluate the correlation between the serum levels of hs- CRP in patients with different levels of asthma control based on ACT scores and spirometric indices. Materials and Methods: The validated Persian version of ACT was administered to one-hundred asthmatic patients. Spirometry was performed and prebronchodilatory FEV1 was measured. Blood samples for CRP measurement were taken and hs-CRP levels were analyzed. Fifty age- matched healthy volunteers comprised the control group. Results: A total of 100 asthmatic patients (57 females and 43 males) and 50 controls were participated. hs-CRP in asthmatics was higher than in controls. No significant differences were found in hs-CRP levels in patients with different levels of asthma control based on ACT (≥20, 16–19, ≤15), GINA classification of asthma control (well controlled, partly controlled, uncontrolled) or FEV1. Conclusion: We found no correlation between degree of systemic inflammation estimated by hs-CRP and other clinical indices of asthma control such as ACT scores, FEV1 and GINA classification of asthma control and even in patients with clinical and spirometric indices of controlled asthma, markers of systemic inflammation were still present.
https://www.tanaffosjournal.ir/article_241011_c2b68938d9267e51f0e8fd50bd036e3f.pdf
2013-10-01
44
48
hs-CRP
Asthma Control Test
Asthma
Naseh
Sigari
1
Department of Internal Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
LEAD_AUTHOR
Hooman
Ghasri
2
Department of Internal Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
AUTHOR
ORIGINAL_ARTICLE
Chest High Resolution Computed Tomography Findings in Connective Tissue Diseases
Background: Lung disorders are important for prognosis of connective tissue disease (CTD). Thus, chest radiography, High Resolution Computed Tomography (HRCT) of the chest and ultrasonic echocardiogram are suggested after the diagnosis of these conditions. The purpose of this study was to evaluate chest HRCT findings in patients with CTD. Materials and Methods: In this descriptive cross-sectional study, we evaluated HRCT findings in patients with (CTD) hospitalized in Imam Reza Hospital in Mashhad from 2006- 2011. Patients’ age, sex, type of rheumatic disease and HRCT results were collected and analyzed by SPSS version 16.0 software. Results: out of 75 patients (78.67% females, 21.33% males with a mean age of 41.6 years), 56% had respiratory symptoms. Scleroderma was the most common disease (38.6%) followed by rheumatoid arthritis (26.6%) and systemic lupus erythematosus (14.6%). Interstitial tissue involvement of the lung was the most frequent finding in patients with scleroderma, dermatomyositis, polymyositis and Sjogren's syndrome (48.3%, 57.1%, 60% and 66.7%, respectively). Pleural thickening was the most common finding in patients with rheumatoid arthritis (45%). Pleural effusion was the most frequent finding in patients with systemic lupus erythematosus (45.4%). Lymphadenopathy and bronchiectasis had the lowest prevalence (1.3%). Conclusion: Our data shows that interstitial tissue involvement, pleural thickening and pleural effusion are common in patients with rheumatic diseases which is consistent with some previous studies.
https://www.tanaffosjournal.ir/article_241012_b1c5a6f22daaaea37535670d2a075005.pdf
2013-10-01
49
52
High resolution computed tomography
Connective tissue diseases
Interstitial tissue involvement
Zahra
Mirfeizi
1
Rheumatic Diseases Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences,
LEAD_AUTHOR
Donya
Farrokh
2
Radiology Ward of Imam Reza Hospital,
AUTHOR
Aida
Javanbakht
3
School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
AUTHOR
Elahe
Raufi
4
School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
AUTHOR
ORIGINAL_ARTICLE
Adiponectin Level in Serum and BAL Sample of Patients with Chronic Obstructive Pulmonary Disease
Background: Chronic obstructive pulmonary disease (COPD) is the only cause of mortality and morbidity with an increasing incidence. Adiponectin has recently gained the spotlight for its possible association with COPD or its exacerbation. This study evaluated the association of serum and alveolar adiponectin levels with COPD-related variables. Materials and Methods: This analytical cross-sectional study was carried out on 45 COPD patients. Number of cigarettes smoked (packs), years of smoking, number of disease exacerbations per year and BMI were all recorded. Patients underwent spirometry and their disease severity was determined based on BODE index. Venous blood sample was obtained to measure the adiponectin serum level, ESR and CRP. Bronchoscopy and BAL were performed as well and alveolar secretions were collected to assess the alveolar fluid level of adiponectin. Results: The mean serum level of adiponectin in COPD patients was significantly higher than the upper limit of normal range in healthy individuals (P=0.000). Level of alveolar adiponectin in smoker patients was significantly higher than non-smokers (P=0.043) but serum adiponectin was not significantly different between them. Serum adiponectin level had a significant reverse correlation with BMI and a direct correlation with number of exacerbations per year and CRP. Level of alveolar adiponectin had a direct association with number of exacerbations per year and number of smoked cigarettes. Conclusion: Based on the obtained results, smoking cessation is very important in COPD and more emphasis should be placed on patient’s weight control especially those with low BMI as well as rehabilitation programs for these patients.
https://www.tanaffosjournal.ir/article_241013_01a4c42c44ad765e4569d45e8bace537.pdf
2013-10-01
53
57
Alveolar adiponectin
Serum adiponectin
Chronic Obstructive Pulmonary Disease (COPD)
Rostam
Yazdani
1
Department of Internal Medicine, Kerman University of Medical Sciences, Kerman, Iran.
AUTHOR
Mohammadreza
Gholamrezapour
2
Department of Internal Medicine, Kerman University of Medical Sciences, Kerman, Iran.
LEAD_AUTHOR
Tarlan
Hassanaghaei
3
Department of Internal Medicine, Kerman University of Medical Sciences, Kerman, Iran.
AUTHOR
ORIGINAL_ARTICLE
A Patient with Moderate Post-Operative Hypertension Presenting with Posterior Reversible Encephalopathy Syndrome: A Case Report
Posterior reversible encephalopathy Syndrome (PRES) is a rare syndrome that is reversible in most cases but can rarely lead to irreversible brain damage and death. Most cases occur after rapid rise in blood pressure. We report a 56 year-old Caucasian male with metastatic adenocarcinoma of the lung who presented with a pleural effusion for which thoracocentesis and thoracotomy were performed. He developed PRES on the third post-operative day following relatively moderate increase in blood pressure. It was diagnosed with diffuse weighted imaging (DWI) MRI. He eventually fully recovered from the event. PRES is a reversible syndrome, in most cases, that can be diagnosed with appropriate imaging studies such as MRI with DWI. This case report is of clinical importance to surgeons as well as neurologists. We speculate that post surgical patients are more prone to developing PRES at lower blood pressures than blood pressures required in healthy individuals to develop PRES. Patients’ post surgical blood pressure should be monitored closely and maintained at lower levels to prevent PRES. It is essential to control and diagnose PRES at an early stage since it can be easily prevented and some cases proceed to irreversible damage. It should also be differentiated from an acute cerebrovascular event since its treatment and prognosis are markedly different from PRES.
https://www.tanaffosjournal.ir/article_241014_579e9050b282b693ce5c8835f74ba329.pdf
2013-10-01
58
61
Posterior reversible encephalopathy syndrome
Nashmia
Riaz
1
Doctors Hospital of Augusta, Augusta, GA-USA
LEAD_AUTHOR
Mehrdad
M. Behnia
2
Doctors Hospital of Augusta, Augusta, GA-USA
AUTHOR
Phillip
W Catalano
3
Doctors Hospital of Augusta, Augusta, GA-USA
AUTHOR
James
Davis
4
Doctors Hospital of Augusta, Augusta, GA-USA
AUTHOR
ORIGINAL_ARTICLE
Pulmonary Botryomycosis Mimicking Bronchogenic Carcinoma of the Lung
Botryomycosis is a relatively rare disease found only in case reports. Most observed cases have been of cutaneous or visceral type. Given the prolonged duration and nature of symptoms, pulmonary botryomycosis may be mistaken for malignancy. We report the first case of pulmonary botryomycosis in Iran initially mimicking bronchogenic carcinoma.
https://www.tanaffosjournal.ir/article_242192_541c626a3c43127667617e8393331d2c.pdf
2013-10-01
62
64
Botryomycosis
Bronchogenic Carcinoma
Lung
Ali
Alavi
1
Respiratory Diseases & TB Research Center of Guilan University of Medical Science(GUMS) - Razi HospitalRasht- Iran
AUTHOR
Manoucher
Aghajanzadeh
2
Respiratory Diseases & TB Research Center of Guilan University of Medical Science(GUMS) - Razi HospitalRasht- Iran
AUTHOR
Korosh
Asgari
3
Respiratory Diseases & TB Research Center of Guilan University of Medical Science(GUMS) - Razi HospitalRasht- Iran
AUTHOR
Sara
Massahnia
4
Respiratory Diseases & TB Research Center of Guilan University of Medical Science(GUMS) - Razi HospitalRasht- Iran
LEAD_AUTHOR
ORIGINAL_ARTICLE
Simple Screening of Pulmonary Artery Hypertension Using Standard Chest X Ray: An Old Technique, New Landmark
Background: Pulmonary artery hypertension (PAH) is difficult to diagnose because of its nonspecific symptoms. Although echocardiography can reliably and rapidly recognize the presence of pulmonary hypertension, chest X ray (CXR) is
https://www.tanaffosjournal.ir/article_241008_9c069e92b8e74538576413817f357432.pdf
1999-11-30
Majid Mirsadraee
Mirsadraee
1
Department of Pulmonary Medicine, Islamic Azad University, Mashhad Branch,
LEAD_AUTHOR
Saeed
Nazemi
2
Cardiologist, Razavi Hospital,
AUTHOR
Ali
Hamedanchi
3
Cardiologist, Razavi Hospital,
AUTHOR
Saeed
Naghibi
4
Department of Radiology, Islamic Azad University, Mashhad Branch, Mashhad, Iran.
AUTHOR