National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranTANAFFOS (Respiration)1735-034413420141201Anthracosis of the Lungs: Etiology, Clinical Manifestations and Diagnosis: A Review113240891ENMajidMirsadraeeDepartment of Internal Medicine, 22th of Bahman
Hospital, Islamic Azad University, Mashhad Branch,
Mashhad, Iran.Journal Article20201227Anthracosis of the lungs is black discoloration of bronchial mucosa that can occlude bronchial lumen and is associated with bronchial anthracofibrosis (BAF). This disease usually presents with a chronic course of dyspnea and or cough in an elderly non-smoker woman or man. In addition, concomitant exposure to dust and wood smoke is the most postulated etiology for anthracosis. Pulmonary function tests usually show an obstructive pattern with no response to bronchodilators and normal DLCO, but some cases with restrictive pattern have also been seen. Computed tomography (CT) may show more specific findings such as lymph node or bronchial calcification and mass lesions. Final diagnosis can be made by bronchoscopy when obtaining samples for tuberculosis (TB), which is the most common disease associated with BAF. Endobronchial ultrasound shows a hypoechoic scattered nodular pattern in adjacent lymph nodes, which is unique to anthracosis. Treatment is very similar to that of chronic obstructive pulmonary disease (COPD) with a chronic course and low mortality. This review discusses this disease as a separate entity; hence, anthracosis should be added to the list of obstructive lung diseases and benign mass lesions and differentiated from biomass induced COPD.https://www.tanaffosjournal.ir/article_240891_800e636c0a24ac3767701a789a96ba89.pdfNational Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranTANAFFOS (Respiration)1735-034413420141201Clinical and Radiographic Manifestations and Treatment Outcome of Pulmonary Tuberculosis in the Elderly in Khuzestan, Southwest Iran1419240892ENSeyed MohammadAlaviHealth institute, Infectious and Tropical Diseases
Research Center, Jundishapur University of Medical
Sciences, Ahvaz, Iran,PejmanBakhtyariniaKhuzestan Health Center,
Jundishapur University of Medical Sciences, Ahvaz, IranFatemehHematniaKhuzestan Health Center,
Jundishapur University of Medical Sciences, Ahvaz, IranAliAlbagiKhuzestan Health Center,
Jundishapur University of Medical Sciences, Ahvaz, IranJournal Article20201227Background: Presentation of pulmonary tuberculosis (PTB) in the elderly is expected to be different from that in younger patients because of the debilitating factors and comorbidities. This issue should be considered in the national tuberculosis programs of countries. The purpose of this study was to evaluate the differences in the clinical and radiographic manifestations and treatment outcomes of PTB between the elderly and young patients. Materials and Methods: This study was conducted as part of a mega project on tuberculosis by the Infectious and Tropical Diseases Research Centre affiliated to Ahvaz Jundishapur University of Medical Sciences. We retrospectively analyzed the medical records of 2,080 relatively young (18–64 years old at the time of diagnosis) and 346 elderly (≥65 years) PTB patients, who had been recently diagnosed and treated in the TB unit of Khuzestan Health Center from 2005 to 2010. Results: Dyspnea and hemoptysis were the most common symptoms and the frequency of positive sputum smear –AFB was lower in the elderly PTB patients. On chest X-ray, elderly patients were less likely to have cavitation in comparison with younger patients. The frequency of favourable treatment outcome in the elderly was significantly lower than that in younger patients (64% vs. 77%, P = 0.003). Conclusion: Dyspnea, weight loss and hemoptysis were more common in the elderly PTB patients. Chest X-ray showed less frequent typical findings of active PTB such as cavitation; and microscopic examination showed fewer sputum smear AFB positive cases in the elderly. The treatment outcome was less favorable in the elderly compared to younger TB patients.https://www.tanaffosjournal.ir/article_240892_18e37deb2d36f25d6c38800f94afab02.pdfNational Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranTANAFFOS (Respiration)1735-034413420141201Predictors of Non-Invasive Ventilation Failure in Severe Respiratory Failure Due to Community Acquired Pneumonia2028240893ENAntonelloNicoliniRespiratory and Internal Medicine Department ASL4
Chiavarese, Italy,Ines MariaGrazia PiroddiRespiratory and Internal Medicine Department ASL4
Chiavarese, Italy,CorneliusBarlasciniPublic Health Department ASL4
Chiavarese, Italy,RenataSenaregaDepartment of Radiology ASL 4
Chiavarese, Italy.Journal Article20201227Background: Non-invasive ventilation (NIV) has been used for acute respiratory failure to avoid endotracheal intubation and intensive care admission. Few studies have assessed the usefulness of NIV in patients with severe community acquired pneumonia (CAP). The use of NIV in severe CAP is controversial because there is a greater variability in success compared to other pulmonary conditions. Materials and Methods: We retrospectively followed 130 patients with CAP and severe acute respiratory failure (PaO2/FiO2 < 250) admitted to a Respiratory Monitoring Unit (RMU) and underwent NIV. We assessed predictors of NIV failure and hospital mortality using univariate and multivariate analyses. Results: NIV failed in 26 patients (20.0%). Higher chest X-ray score at admission, higher heart rate after 1 hour of NIV, and a higher alveolararteriolar gradient (A-aDO2) after 24 hours of NIV each independently predicted NIV failure. Higher chest X ray score, higher LDH at admission, higher heart rate after 24 hours of NIV and higher A-aDO2 after 24 hours of NIV were directly related to hospital mortality. Conclusion: NIV treatment had high rate of success. Successful treatment is related to less lung involvement and to early good response to NIV and continuous improvement in clinical response.https://www.tanaffosjournal.ir/article_240893_e41504730fd53a4f70e993da693ef275.pdfNational Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranTANAFFOS (Respiration)1735-034413419991130Diagnostic Accuracy of Chest Ultrasonography versus Chest Radiography for Identification of Pneumothorax: A Systematic Review and Meta-Analysis2940240894ENAliEbrahimiTrauma Research Center, Baqiyatallah University of
Medial Sciences, Tehran, IranMahmoudYousefifardDepartment of
Physiology, School of Medicine, Tehran University of
Medical Sciences, Tehran, IranHosseinMohammad KazemiTrauma Research Center, Baqiyatallah University of
Medial Sciences, Tehran, Iran,Hamid RezaRasouliTrauma Research Center, Baqiyatallah University of
Medial Sciences, Tehran, Iran,HadiAsadyDepartment of
Occupational Health Engineering, Faculty of Public
Health, Tehran University of Medical Sciences, Tehran,
IranAli MoghadasJafarDepartment of Emergency Medicine, School of
Medicine, Bushehr University of Medical Sciences,
Bushehr, Iran,MostafaHosseiniDepartment of Epidemiology and
Biostatistics, Faculty of Public Health, Tehran University
of Medical Sciences, Tehran, Iran.Journal Article20201227Background: Early detection of pneumothorax is critically important. Several studies have shown that chest ultrasonography (CUS) is a highly sensitive and specific tool. The present systematic review and meta-analysis was designed to evaluate the diagnostic accuracy of CUS and chest radiography (CXR) for detection of pneumothorax. Materials and Methods: The literature search was conducted using PubMed, EMBASE, Cochrane, CINAHL, SUMSearch, Trip databases, and review article references. Eligible articles were defined as diagnostic studies on patients suspected for pneumothorax who underwent chest computed tomography (CT) scan and those assessing the screening role of CUS and CXR. Results: The analysis showed the pooled sensitivity and specificity of CUS were 0.87 (95% CI: 0.81-0.92; I2= 88.89, p <0.001) and 0.99 (95% CI: 0.98-0.99; I2= 86.46, p <0.001), respectively. The pooled sensitivity and specificity of CXR were 0.46 (95% CI: 0.36-0.56; I2= 85.34, p <0.001) and 1.0 (95% CI: 0.99-1.0; I2= 79.67, p <0.001), respectively. The Meta regression showed that the sensitivity (0.88; 95% CI: 0.82 - 0.94) and specificity (0.99; 95% CI: 0.98 - 1.00) of ultrasound performed by the emergency physician was higher than by non-emergency physician. Non-trauma setting was associated with higher pooled sensitivity (0.90; 95% CI: 0.83 – 0.98) and lower specificity (0.97; 95% CI: 0.95 – 0.99). Conclusion: The present meta-analysis showed that the diagnostic accuracy of CUS was higher than supine CXR for detection of pneumothorax. It seems that CUS is superior to CXR in detection of pneumothorax, even after adjusting for possible sources of heterogeneity.https://www.tanaffosjournal.ir/article_240894_06c1b6af918d033b6e09835ffeda44f4.pdfNational Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranTANAFFOS (Respiration)1735-034413420141201Qualification Study of Two Genomic DNA Extraction Methods in Different Clinical Samples4147240895ENAlirezaJavadiMycobacteriology Research Center, National Research
Institute of Tuberculosis and Lung Diseases (NRITLD),
Shahid Beheshti University of Medical Sciences, Tehran,
IranMasoudShamaeiClinical Tuberculosis and Epidemiology Research
Center, National Research Institute of Tuberculosis and
Lung Diseases (NRITLD), Shahid Beheshti University of
Medical Sciences, Tehran, IranLeila MohammadiZiaziPediatric Respiratory
Diseases Research Center, National Research Institute
of Tuberculosis and Lung Diseases (NRITLD), Shahid
Beheshti University of Medical Sciences, Tehran, Iran,MihanPourabdollahPediatric Respiratory
Diseases Research Center, National Research Institute
of Tuberculosis and Lung Diseases (NRITLD), Shahid
Beheshti University of Medical Sciences, Tehran, Iran,AtosaDorudiniaChronic Respiratory Diseases Research Center,
National Research Institute of Tuberculosis and Lung
Diseases (NRITLD), Shahid Beheshti University of
Medical Sciences, Tehran, Iran.Seyed MohammadSeyedmehdiChronic Respiratory Diseases Research Center,
National Research Institute of Tuberculosis and Lung
Diseases (NRITLD), Shahid Beheshti University of
Medical Sciences, Tehran, Iran.ShirinKarimiMycobacteriology Research Center, National Research
Institute of Tuberculosis and Lung Diseases (NRITLD),
Shahid Beheshti University of Medical Sciences, Tehran,
Iran,Journal Article20201227Introduction: The purity of genomic DNA (gDNA) extracted from different clinical specimens optimizes sensitivity of polymerase chain reaction (PCR) assays. This study attempted to compare two different DNA extraction techniques namely salting-out and classic phenol-chloroform. Materials and Methods: Qualification of two different DNA extraction techniques for 634 clinical specimens highly suspected of having mycobacterial infection was performed. Genomic DNA was extracted from 330 clinical samples using phenol-chloroform and 304 by non-toxic salting-out. Qualification of obtained gDNA was done through amplification of internal controls, β-actin and β-globin. Results: β-actin-positive was detected in 279/330 (84%) and 272/304 (89%) samples by phenol-chloroform technique and salting-out, respectively. PCR inhibitor was found for the gDNA of 13/304 (4%) patient samples were negative by β-actin and β-globin tests via salting-out technique in comparison with gDNAs from 27/330 (8.5%) samples extracted by phenol-chloroform procedure. No statistically significant difference was found between phenolchloroform technique and salting-out for 385 sputum, 29 bronchoalveolar lavage (BAL), 105 gastric washing, and 38 body fluid (P=0.04) samples. This illustrates that both techniques have the same quality for extracting gDNA. Conclusion: This study discloses salting-out as a non-toxic DNA extraction procedure with a superior time-efficiency and cost-effectiveness in comparison with phenol-chloroform and it can be routinely used in resource-limited laboratory settings.https://www.tanaffosjournal.ir/article_240895_29bff3632b1337102fd98773e64bfc36.pdfNational Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranTANAFFOS (Respiration)1735-034413420141201Evaluation of Bronchoscopy Complications in a Tertiary Health Care Center4850240896ENHelenazFazlalizadehTracheal Diseases Research Center, National
Research Institute of Tuberculosis and Lung Disease
(NRITLD), Shahid Beheshti University of Medical
Sciences, Tehran, IranParisaAdimiChronic Respiratory Diseases
Research Center, NRITLD, Shahid Beheshti University of
Medical Sciences, Tehran, Iran.ArdaKianiTracheal Diseases Research Center, National
Research Institute of Tuberculosis and Lung Disease
(NRITLD), Shahid Beheshti University of Medical
Sciences, Tehran, Iran,MajidMalekmohammadTracheal Diseases Research Center, National
Research Institute of Tuberculosis and Lung Disease
(NRITLD), Shahid Beheshti University of Medical
Sciences, Tehran, Iran,Hamid RezaJabardarjaniTracheal Diseases Research Center, National
Research Institute of Tuberculosis and Lung Disease
(NRITLD), Shahid Beheshti University of Medical
Sciences, Tehran, IranForoughSoltaninejadTracheal Diseases Research Center, National
Research Institute of Tuberculosis and Lung Disease
(NRITLD), Shahid Beheshti University of Medical
Sciences, Tehran, Iran0000-0002-4409-5836Seyed Mohammad RezaHashemianChronic Respiratory Diseases
Research Center, NRITLD, Shahid Beheshti University of
Medical Sciences, Tehran, Iran.Journal Article20201227Background: Bronchoscopy is a technique of visualizing the inside of the airways for diagnostic and therapeutic purposes. This study was performed to determine the complications of bronchoscopy in a tertiary health-care center. Materials and Methods: This study had as descriptive cross sectional design. Four hundred adult patients between 16 to 85 years, who underwent bronchoscopy with a same method and same device and had no underlying disease, were consecutively enrolled. Results: Bronchoscopy complications were seen in 13 patients (3.25%) including bleeding (four cases), pneumothorax (three cases), collapse (four cases), and infection (two cases). There was no association between complications and age, sex, bronchoscopy indications and findings (P > 0.05). Conclusion: According to the obtained results, it may be concluded that bronchoscopy can be performed safely whenever indicated. Complications occurred were minor and self limitinghttps://www.tanaffosjournal.ir/article_240896_828a3d12818610d43d285adf75e895c3.pdfNational Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranTANAFFOS (Respiration)1735-034413420141201A Piece of Broken Metal from Intubation Stylet Retained in Tracheobronchial Tree: A Case Report5154240897ENMohammadFathiAnesthesiology Department, Shahid Modarres Hospital,
Faculty of Medicine, Shahid Beheshti University of
Medical Sciences, Tehran, Iran,BehroozFarzaneganTracheal Diseases
Research Center, National Research Institute of
Tuberculosis and Lung Diseases (NRITLD), Shahid
Beheshti University of Medical Sciences, Tehran, Iran,MeysamMojtabaeeTracheal Diseases
Research Center, National Research Institute of
Tuberculosis and Lung Diseases (NRITLD), Shahid
Beheshti University of Medical Sciences, Tehran, Iran,AbdolrahimNikzamirDepartment of Biochemistry, Faculty of Medicine,
Shahid Beheshti University of Medical Sciences,
Tehran, IranJournal Article20201227Intubation stylets are still being used in many medical centers for difficult intubations. Although very rare, it may break inside the trachea during endotracheal intubation despite routine pre-assessments by anesthesiologists and may surprisingly move deep into the tracheobronchial tree. In this case report, we describe a rare complication after stylet or guide-wire intubation in a patient in whom, a broken piece of metal guide remained in his tracheobronchial tree for 3 days. A 62 year-old man was admitted to our hospital with the chief complaint of functional class 3 dyspnea. The patient was a known case of chronic obstructive pulmonary disease (COPD) from 3 years ago with a history of heavy smoking (40 p/y) and oral opioid usage. We report a case with an unrecognized broken piece of stylet in his trachea and left main bronchus, which was later detected by CT scan and extracted before causing pressure rise symptoms in the airway. Despite precise evaluation before use, signs of breakage in the stylet may be missed and consequently, it may break inside the trachea and result in serious complications. It is strongly recommended that the anesthesiologists pay attention to the sounds and movements of the instruments. This article also briefly reviews the most serious reported complications due to stylet breakage.https://www.tanaffosjournal.ir/article_240897_125351a298203928d78593d8ba773cc4.pdfNational Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranTANAFFOS (Respiration)1735-034413420141201Huge Hilar Carcinoid Tumor Resected by Transsternal Pneumonectomy: A Case Presentation5557240898ENAli BiharasMonfaredLung Transplantation Research Center, National
Research Institute of Tuberculosis and Lung Diseases
(NRITLD), Shahid Beheshti University of Medical
Sciences, Tehran, Iran,LeilaMosadeghChronic Respiratory Diseases
Research Center, (NRITLD), Shahid Beheshti University
of Medical Sciences, Tehran, Iran.AbolghasemDaneshvar Kakhaki1 Lung Transplantation Research Center, National
Research Institute of Tuberculosis and Lung Diseases
(NRITLD), Shahid Beheshti University of Medical
Sciences, Tehran, Iran,Journal Article20201227Carcinoid tumors comprise an uncommon group of pulmonary neoplasms with neuroendocrine origin. In comparison with typical carcinoid tumors, atypical tumors are less common and more aggressive. We present a 35-year old female with atypical carcinoid tumor. The mass was located centrally and transsternal pneumonectomy was performed to resect the tumor.https://www.tanaffosjournal.ir/article_240898_33f082b6676764bdc03f86d7fe1ae199.pdfNational Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranTANAFFOS (Respiration)1735-034413420141201Unilateral Pulmonary Artery Agenesis in an Adult Patient with Cough and Hemoptysis: A Case Report5860240899ENAli BiharasMonfaredLung Transplantation Research Center, National
Research Institute of Tuberculosis and Lung Diseases
(NRITLD), Shahid Beheshti University of Medical
Sciences, Tehran, Iran,LeilaMosadeghChronic Respiratory Diseases
Research Center, (NRITLD), Shahid Beheshti University
of Medical Sciences, Tehran, Iran.AbolghasemDaneshvar KakhakiLung Transplantation Research Center, National
Research Institute of Tuberculosis and Lung Diseases
(NRITLD), Shahid Beheshti University of Medical
Sciences, Tehran, Iran,Seyed Ali JavadMoosaviDepartment of Pulmonary Medicine, Iran University of
Medical Sciences, Tehran, Iran.AidaIranpourDepartment of Pulmonary Medicine, Iran University of
Medical Sciences, Tehran, Iran.Journal Article20201227Unilateral pulmonary artery agenesis (UPAA) is an uncommon congenital anomaly and most patients present in neonatal period with respiratory symptoms. Left-sided pulmonary artery agenesis is less frequent than rightsided and is sometimes associated with cardiac anomalies. We report a patient with a history of repaired ventricular septal defect, who presented with cough and hemoptysis and the diagnosis of UPAA was made.https://www.tanaffosjournal.ir/article_240899_6114b85833e313279acff1f0fb7a9e2b.pdf