National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranTANAFFOS (Respiration)1735-034417120180101Imbalanced Expression of Th2 and Treg Cell-related Parameters in Peripheral Blood Mononuclear Cells in Patients with Allergic Asthma112240090ENSamane Hoseini-ShahrestanakDepartment of Immunology, Medical School, Kerman University of Medical Sciences, Kerman, IranNasrin BazarganDepartment of Internal Medicine, Medical School, Kerman University of Medical Sciences, Kerman, IranLeila RahimianDepartment of Immunology, Medical School, Kerman University of Medical Sciences, Kerman, IranMaryam NematiDepartment of Laboratory Sciences, Para-Medical School, Kerman University of Medical Sciences, Kerman, IranSaeed SolaymaniDepartment of Immunology, Medical School, Kerman University of Medical Sciences, Kerman, IranAbdollah JafarzadehDepartment of Immunology, Medical School, Kerman University of Medical Sciences, Kerman, IranDepartment of Immunology, Medical School, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.Journal Article20201222<strong>Background:</strong> 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.<br /> <strong>Material and Methods: </strong>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 <em>GATA3</em> and <em>FOXP3</em> 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.<br /> <strong>Results:</strong> The serum levels of IL-4, the expression level of <em>GATA3</em>, and <em>GATA3/FOXP3</em> ratio in patients with asthma were significantly higher than healthy subjects (P <0.002, P <0.001, and P <0.004, respectively). The <em>FOXP3</em> 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 GTAT3/FOXP3 expression ratio in moderate asthma was significantly higher than severe form (P <0.04).<br /> <strong>Conclusion: </strong>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.https://www.tanaffosjournal.ir/article_240090_5ed5ce124fb6c14776af0991bb394eca.pdfNational Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranTANAFFOS (Respiration)1735-034417120180101The Significance of Serum Interleukin-8 in Acute Exacerbations of Chronic Obstructive Pulmonary Disease1321243014ENJingxi ZhangDepartment of Respiratory and Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, China.Chong BaiDepartment of Respiratory and Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, China.Journal Article20210316<strong>Backgrounds: </strong>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.
<strong>Materials and Methods: </strong>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.
<strong>Results: </strong>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).
<strong>Conclusion: </strong>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.https://www.tanaffosjournal.ir/article_243014_1e50a92d4e09acbcb64fbee83f834829.pdfNational Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranTANAFFOS (Respiration)1735-034417120210316Analgesic Effects of Ketamine, Magnesium Sulfate, and Sodium-Thiopental on Propofol Injection Pain: A Single-Blind Randomized Clinical Trial2228243015ENHooshang AkbariDepartment of Anesthesiology, Mazandaran University of Medical Sciences, Sari, IranEbrahim NasiriTraditional and Complementary Medicine Research Centre, Mazandaran University of Medical Sciences, Sari, IranAttieh NikkhahAntimicrobial Resistant Nosocomial Infection Research Center, Mazandaran University of Medical Sciences, Sari, IranSeyed Hossein ArdehaliDepartment of Critical Care, Shohaday-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IranJournal Article20210316<strong>Background: </strong>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.<br /> <strong>Materials and Methods:</strong> 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.<br /> <strong>Results:</strong> 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).<br /> <strong>Conclusion:</strong> 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.https://www.tanaffosjournal.ir/article_243015_6e6fcaa28c90f93865b98de3ab154428.pdfNational Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranTANAFFOS (Respiration)1735-034417120180101Effects of Cold Application on Chest Tube Removal Pain in Heart Surgery Patients2936243016ENNooredin MohammadiDepartment of Critical Care Nursing, Nursing and Midwifery Faculty, Centre for Nursing Care Research, Iran University of Medical Sciences, Tehran, IranAli PooriaDepartment of Cardiac Surgery, Lorestan University of Medical Sciences, Khorramabad, IranSajad YarahmadiSocial Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, IranMohammad Javad TarrahiDepartment of Bio-statistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, IranHassan NajafizadehSocial Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, IranPayam AbbasiChronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranBehzad MoradiSocial Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, IranJournal Article20210316<strong>Background: </strong>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.<br /> <strong>Materials and Methods:</strong> 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.<br /> <strong>Results:</strong> 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).<br /> <strong>Conclusion:</strong> Cold application, as a nonpharmacological intervention, may contribute to the alleviation of cryotherapy-related pain.https://www.tanaffosjournal.ir/article_243016_0971f1524abaa4764a565f06afe53cba.pdfNational Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranTANAFFOS (Respiration)1735-034417120180101Pulmonary Function and Hospital Admission in Patients with Cystic Fibrosis Based on Household Second-Hand Smoking3741243017ENMaryam HassanzadPediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranShabnam EslampanahTobacco Prevention and Control Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences ,Tehran, IranMohammadreza ModaresiPediatric Pulmonary Disease and Sleep Medicine Research Center, Pediatric Center of Excellence, Children’s Medical Center, Tehran, IranSabereh Tashayoie-NejadPediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranAli Akbar VelayatiPediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranJournal Article20210316<strong>Background: </strong>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.
<strong>Materials and Methods:</strong> 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.
<strong>Results:</strong> 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).
<strong>Conclusion:</strong> 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.https://www.tanaffosjournal.ir/article_243017_666ce6a8b3d42062aa5c0ba712257bcd.pdfNational Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranTANAFFOS (Respiration)1735-034417120180101Assessment of Pulmonary Function Parameters, Signs, and Symptoms in the Employee of a Dairy Products Company in Tehran, Iran4246243018ENMohammad Hassan Nassiri-KashaniOccupational Medicine Research Center, Iran University of Medical Sciences, Tehran, IranMashallah AghilinejadOccupational Medicine Research Center, Iran University of Medical Sciences, Tehran, IranAmir Bahrami-AhmadiOccupational Medicine Research Center, Iran University of Medical Sciences, Tehran, IranOmid MoslemiOccupational Medicine Research Center, Iran University of Medical Sciences, Tehran, IranElahe Kabir-MokamelkhahOccupational Medicine Research Center, Iran University of Medical Sciences, Tehran, IranJournal Article20210316<strong>Background: </strong>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.
<strong>Materials and Methods:</strong> 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 FEV<sub>1</sub>, forced volume vital capacity (FVC), and FEV<sub>1</sub>/FVC were measured for the study participants.
<strong>Results:</strong> 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 FEV<sub>1 </sub>were significantly less than the predicted amount in the exposed group than in the unexposed group.
<strong>Conclusion:</strong> 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.https://www.tanaffosjournal.ir/article_243018_0feeb5026ba1a19d9d81a05937afcab7.pdfNational Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranTANAFFOS (Respiration)1735-034417120180101Effect of Family Empowerment on Asthma Control in School-Age Children4752243019ENZahra KashaniniaDepartment of Pediatric Nursing, Faculty of Nursing and Midwifery , Iran University of Medical Sciences, Tehran- IranZahra PayroveePediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranReza SoltaniDepartment of Statistics, University of Social Welfare and Rehabilitation Sciences, Tehran, IranSeyed Alireza MahdavianiPediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran0000-0001-6224-4797Journal Article20210316<strong>Background: </strong><strong>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.</strong><br /> <strong>Materials and Methods:</strong> <strong>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.</strong><br /> <strong>Results:</strong> <strong>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).</strong><br /> <strong>Conclusion:</strong> <strong>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.</strong>https://www.tanaffosjournal.ir/article_243019_ad270a1494f59cc150bc9b9281dc2018.pdfNational Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranTANAFFOS (Respiration)1735-034417120180101Successful Treatment of Massive Pulmonary Thromboembolism with Reteplase: Case Series5356243020ENHassan GhobadiDepartment of Internal Medicine, Ardabil University of Medical Sciences, Ardabil, IranZahra AmirajamDepartment of Internal Medicine, Ardabil University of Medical Sciences, Ardabil, IranAfshin HabibzadehDepartment of Internal Medicine, Ardabil University of Medical Sciences, Ardabil, IranJournal Article20210316Massive 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.https://www.tanaffosjournal.ir/article_243020_fbde983a9d02a2d3a5c146118072657d.pdfNational Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranTANAFFOS (Respiration)1735-034417120180101Anesthesia Management of Vitrectomy in a Patient with Sturge-Weber Syndrome5761243021ENFatemeh RoodneshinLabbafinejad Medical Center, Department of Anesthesiology, Shahid Beheshti University of Medical Sciences, Tehran, IranMahtab Poor Zamany Nejat KermanyLabbafinejad Medical Center, Department of Anesthesiology, Shahid Beheshti University of Medical Sciences, Tehran, IranPooya RostamiDepartment of Anesthesiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Hamed TanghatariDepartment of Anesthesiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Journal Article20210316Sturge-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.https://www.tanaffosjournal.ir/article_243021_51bcbd4a94be29f22c31ddde18763ba8.pdfNational Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranTANAFFOS (Respiration)1735-034417120180101A Rare Report of Lung Metastasis of the Common Non-Melanotic Skin Cancer6265243022ENMohsen ShafiepourChronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranArda KianiTracheal Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, IranKimia TaghaviChronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranSharareh SeifiChronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranMitra Sadat RezaieVirology Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, IranSeyed Mohammad Reza HashemianClinical Tuberculosis center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, IranAtefeh AbediniChronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran0000-0002-4262-9873Journal Article20210316Basal 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.https://www.tanaffosjournal.ir/article_243022_ce22dd48212122910cdd44dbea8842f1.pdf