National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 20 2 2021 04 01 Efficacy of Early Prone Positioning Combined with Noninvasive Ventilation in COVID-19 82 85 248014 EN Seyed Mohammadreza Hashemian Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0002-0768-9168 Hamidreza Jamaati Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran Majid Malekmohammad Tracheal Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran Payam Tabarsi Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran Batoul Khoundabi Iran Helal Institute of Applied-Science and Technology, Research Center For Health Management in Mass Gathering, Red Crescent Society of the Islamic Republic of Iran, Tehran, Iran Navid Shafigh Department of Anesthesiology and Critical Care Medicine, School of Medicine, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Journal Article 2021 12 15 https://www.tanaffosjournal.ir/article_248014_14399e19372214e9b1570996dd9adfad.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 20 2 2021 04 01 An Overview on the Upper and Lower Airway Microbiome in Cystic Fibrosis Patients 86 98 248015 EN Maryam Meskini Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran Microbiology Research Center (MRC), Pasteur Institute of Iran, Tehran, Iran Seyed Davar Siadat Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran Microbiology Research Center (MRC), Pasteur Institute of Iran, Tehran, Iran Sharareh Seifi Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases(NRITLD), Shahid Beheshti University of Medical Science, Tehran, Iran Abolfazl Movafagh Department of Medical Genetics, Cancer Research Center, Shohadaye Tajrish Hospital, School of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran. Mojgan Sheikhpour Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran Microbiology Research Center (MRC), Pasteur Institute of Iran, Tehran, Iran Journal Article 2021 12 15 Background: In cystic fibrosis patients, the mucus is an excellent place for opportunistic bacteria and pathogens to cover. Chronic infections of upper and lower airways play a critical role in the mortality of cystic fibrosis. This study aimed to introduce the microbiota profiles in patients with cystic fibrosis. Materials and Methods: In this study, a comprehensive literature search was done for studies on upper and lower airway microbiota in cystic fibrosis patients. International and national databases were searched for the following MeSH words: microbiota, microbiome, upper airway, lower airway, cystic fibrosis, cystic fibrosis, upper airway microbiome, lower airway microbiome, microbiome pattern in cystic fibrosis, microbiome pattern in cystic fibrosis, upper airway microbiota, lower airway microbiota, and microbiota pattern. Results: Streptococcus spp. are in significantly higher relative abundance in infants and children with cystic fibrosis; however, Pseudomonas spp. are in higher relative abundance in adults with cystic fibrosis. Molecular diagnostic techniques can be remarkably accurate in detecting microbial strains. Conclusion: For the detection and isolation of most bacterial species, independent-culture methods in addition to the standard culture method are recommended, and sampling should include both upper and lower airways.

https://www.tanaffosjournal.ir/article_248015_149af25e89937a5f60d0da06580942a1.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 20 2 2021 04 01 Role of Clinical and Echocardiographic Findings in Patients with Acute Pulmonary Embolism: Prediction of Adverse Outcomes and Mortality in 180 Days 99 108 248016 EN Neda Akhoundi Department of Radiology, Modarres Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Taraneh Faghihi Langroudi Department of Radiology, Modarres Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Elmira Rezazadeh Department of Radiology, Modarres Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Hamid Rajebi University of Texas Health at San Antonio, San Antonio, TX, USA Javad Komijani Bozchelouei Department of Radiology, Modarres Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Sonia Sedghian Tabriz University of Medical Sciences, Tabriz, Iran. Tohid Sarfaraz Tabriz University of Medical Sciences, Tabriz, Iran. Negar Heydari Tabriz University of Medical Sciences, Tabriz, Iran. Journal Article 2021 12 15 Background: Pulmonary embolism (PE) can be a possibly mortal disease; therefore, an immediate risk assessment would be imperative to ensure accurate decisions on proper treatment plans. The focus of the present study was to evaluate the prognostic value of clinical, echocardiographic, and helical pulmonary computed tomography angiography findings for adverse outcomes and mortality. Materials and Methods: A total of 104 patients with PE were retrospectively entered in the present study. Patients were categorized into five groups, including patients who faced an adverse outcome (group 1), patients who expired in 30 days (group 2), patients who expired in 30-90 days (group 3), patients who expired in 90-180 days (group 4), and patients who survived without facing an adverse outcome (group 5). Comorbidities (e.g., malignancy) were obtained from medical records. Logistic regression analysis was performed to detect mortality predictors. Results: In this study, 16 patients were faced with an adverse outcome. Furthermore, 10, 5, and 2 deaths occurred within 30, 30-90, and 90-180 days, respectively. The most frequent presentation was dyspnea (89%). The mean intensive care unit stay (OR=1.202; P=0.036), the predicted 30-day mortality, and a history of kidney transplantation (OR=0.011; P=0.002) were related to less probability of death within 30 days. Conclusion: The results of this study revealed that a history of kidney transplantation is independently accompanied by a lower occurrence of expiration in 30 days. Moreover, there was a significant correlation between the pulmonary embolism severity index, heart rate of > 100 beats per minute, chest pain, hypoxia, and pulmonary arterial pressure with the pulmonary artery obstruction index (PAOI).

https://www.tanaffosjournal.ir/article_248016_ef5b4db2516109190e943a3d7c8793d4.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 20 2 2021 04 01 Perceived Asthma Control Care and Health Care Participation in Patients with Asthma 109 115 248071 EN Mohammad Ali Haghighati Medical Informatics Research Center, Kerman University of Medical Sciences, Kerman, Iran Leila Vali Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran Reza Goudarzi Department of Health Policy Management and Economics, School of Medical Management and Information, Kerman University of Medical Sciences, Kerman, Iran Mitra Samareh Fekri Department of Internal Medicine, Kerman University of Medical Sciences, Kerman, Iran Rahil Ghorbani Nia Candidate in Healthcare Services Management, School of Healthcare Management, Kerman University of Medical Sciences, Kerman, Iran Journal Article 2021 12 16 Background: Asthma is one of the most severe and life-threatening health problems, the better control of which is one of the main goals in asthma management to be achieved by patients’ balanced participation in the treatment process. This study aimed to investigate asthma control, perceived care, and health care participation in patients with asthma. Materials and Methods: This descriptive-analytical study included 221 asthmatic patients, who were selected using the convenience sampling method from those referring to pulmonary clinics in Kerman, Iran. The required data were collected using three questionnaires including Asthma Control Test (ACT), Perceived Care of Asthma Questionnaire (PCAQ), and Partners in Health Scale (PIH). The linear regression test was used to analyze the collected data with SPSS software version 21. Results: In this study, 14.31, 42.22, and 87.33% of the patients had a favorable condition in asthma control, perceived asthma care, health participation, respectively. The disease duration was significantly associated with the level of perceived asthma care. Moreover, perceived asthma care had a significant relationship only with occupation. From another perspective, the relationship between marital status, level of education, city of residence, disease duration, and occupation with health care participation was significant. Conclusion: Patients would have more control over asthma if there were training programs underpinned by disease-based strategies and educational content regarding the risk factors of the disease, and the patients’ experience and knowledge of the disease were promoted. Furthermore, reinforcing self-control and perceived asthma care skills and involving patients in healthcare process would also enhance the disease control.

https://www.tanaffosjournal.ir/article_248071_e624dbd2fdc10d7916228b7acb68d043.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 20 2 2021 04 01 Prevalence of Sleep Apnea and its Associated Factors in Chronic Kidney Disease Patients 116 125 248072 EN Maliheh Moradzadeh Department of Internal Medicine, Kosar Hospital, Semnan University of Medical Sciences, Semnan, Iran Majid Mirmohammadkhani Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran Mohammad Reza Tamadon Department of Internal Medicine, Kosar Hospital, Semnan University of Medical Sciences, Semnan, Iran Kamyar Mansori Department of Biostatistics and Epidemiology, School of Medicine , Zanjan University of Medical Sciences, Zanjan, Iran Farhad Malek Department of Internal Medicine, Kosar Hospital, Semnan University of Medical Sciences, Semnan, Iran Journal Article 2021 12 16 Background: This study aimed to determine the prevalence of sleep apnea and its associated factors in patients with chronic kidney disease (CKD). Materials and Methods: This population-based cross-sectional study included 47 CKD patients, referred to the dialysis unit of Kosar Hospital in Semnan, Iran, in 2017. Two questionnaires were used for data collection. The first questionnaire included demographic and clinical variables, and the second questionnaire (STOP-BANG questionnaire) was used to measure sleep apnea in CKD patients. Also, the Apnea-Hypopnea Index (AHI) was calculated for all patients and was considered as the gold standard. To determine the factors associated with sleep apnea, univariate and multiple logistic regression models were used. Finally, the area under the receiver operating characteristic curve (ROC) was determined for assessing the discriminative ability of the model, as well as the accuracy of STOP-BANG questionnaire. STATA version 14 was used for data analysis. Results: The prevalence of sleep apnea in CKD patients was 53.2%. Also, its prevalence in women and men was 52% and 48%, respectively. In the multiple logistic regression model, body mass index (BMI) (OR: 1.21, 95% CI: 1.04-1.31) and blood urea nitrogen (BUN) (OR: 0.94, 95% CI: 0.91-0.98) had significant associations with sleep apnea in CKD patients; the area under the ROC curve was 0.7982 for this model. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the ROC curve of STOP-BANG questionnaire for AHI≥15 were 71.43, 61.54, 60, 72.73, and 0.6932, respectively. Conclusion: This study showed that the prevalence of sleep apnea in CKD patients was high. Given the acceptable validity of STOP-BANG questionnaire, this scale can be used to screen sleep apnea in CKD patients.

https://www.tanaffosjournal.ir/article_248072_d59e339a5ac8067fe322e9b3dc9d28ab.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 20 2 2021 04 01 Gene Expression and In Vitro Pharmacogenetic Studies of Dopamine and Serotonin Gene Receptors in Tuberculosis 126 133 248017 EN Mojgan Sheikhpour Department of Mycobacteriology and Pulmonary Research, Microbiology Research Center, Pasteur Institute of Iran, Tehran, Iran Mohammad Ali Shokrgozar Department of Medical Genetics and Molecular Medicine, Faculty of Medicine, Zanjan University, Zanjan, Iran Alireza Biglari National Cell Bank, Pasteur Institute of Iran, Tehran, Iran Majid Pornour Photo Healing and Regeneration Research Group, Medical Laser Research Center, ACECR, Tehran, Iran Farid Abdolrahimi Department of Mycobacteriology and Pulmonary Research, Microbiology Research Center, Pasteur Institute of Iran, Tehran, Iran Shahin Poorazar Dizaji Department of Mycobacteriology and Pulmonary Research, Microbiology Research Center, Pasteur Institute of Iran, Tehran, Iran Sharareh Khanipour Department of Mycobacteriology and Pulmonary Research, Microbiology Research Center, Pasteur Institute of Iran, Tehran, Iran Morteza Masoumi Department of Mycobacteriology and Pulmonary Research, Microbiology Research Center, Pasteur Institute of Iran, Tehran, Iran Nayereh Ebrahimzadeh Department of Mycobacteriology and Pulmonary Research, Microbiology Research Center, Pasteur Institute of Iran, Tehran, Iran Hanieh Abolfathi Department of Mycobacteriology and Pulmonary Research, Microbiology Research Center, Pasteur Institute of Iran, Tehran, Iran Journal Article 2021 12 15 Background: Dopamine and serotonin receptors are present in lymphocytes, macrophages, and neutrophils, and have a mediating role in the immune system to respond to infections, including bacterial tuberculosis. Materials and Methods: In this study, at first, the changes in the expression pattern of 5 dopamine and 2 serotonin (5HTR2B & 5HTR2C) gene receptors were examined in the two groups of healthy and Tuberculosis patients using Real-Time PCR. Then pharmacogenetic studies aimed to induce autophagy on a lung monocyte cell line (THP1) infected with the standard strain of Mycobacterium tuberculosis (H37RV) were performed. Stimulation of the pro-inflammatory pathway by secreting cytokines before and after drug efficacy was investigated. Results: According to the result, dopamine receptor 2 genes showed decreased expression in patients with tuberculosis compared to normal individuals, and serotonin receptor genes showed increased expression. Additionally, with the effects of Bromocriptine and Fluoxetine, pro-inflammatory pathways were activated in macrophages infected with H37RV, and ELISA results showed that the levels of IL6 and TNFα secreted in these cells were significantly increased. Conclusion: According to the results, these receptors agonists or antagonists can activate the autophagy pathway to kill TB bacteria.

https://www.tanaffosjournal.ir/article_248017_7013b9c98a4952ae58fbf8b9b9cf2423.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 20 2 2021 04 01 Bronchial Angioembolization for Management of Hemoptysis Due to Pulmonary Tuberculosis 134 139 248073 EN Seyed Reza Seyyedi Lung Transplantation Research Center, Department of Cardiology, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran Payam Tabarsi Clinical Tuberculosis and Epidemiology Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran Makan Sadr Virology Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran Oldooz Aloosh Chronic Respiratory Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mohammad Sadegh Keshmiri Chronic Respiratory Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran Atefeh Abedini Chronic Respiratory Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran Majid Marjani Clinical Tuberculosis and Epidemiology Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0003-1466-8645 Afshin Moniri Clinical Tuberculosis and Epidemiology Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mandana Chitsazan Chronic Respiratory Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mojdeh Azimi Chronic Respiratory Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran Babak Sharif-Kashani Lung Transplantation Research Center, Department of Cardiology, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran Journal Article 2021 12 16 Background: The study aimed to evaluate the effectiveness and safety of BAE in TB patient with massive hemoptysis and evaluate the recurrence rate of hemoptysis after BAE. Materials and Methods: In this prospective study, 68 patients with moderate and severe hemoptysis due to active or old tuberculosis who underwent bronchial arteriography were included. CXR and CT scan were performed in all patients. Selective and nonselective bronchial artery angiography was performed in all patient and 62 patients underwent embolization. Results: Thirty-two patients (47.1%) had active TB and 36 patients (52.9%) had inactive TB (post-tuberculosis sequelae). Abnormality was detected in a single vessel in 30 (44.1%) patients, in two vessels in 23 (33.8%) and in more than two vessels in 13 (19.1%) patients. Embolization was performed in 62 patients and overall 95 abnormal arteries were embolized. Hemoptysis control rate was 82.3% at one month, 73.5% at three months, 69.1 % at 6 months, 63.2% at one year and 60.3% after two years. Conclusion: No major complication occurred as a result of BAE procedures. BAE is a safe and effective method for the management of hemoptysis in patient with tuberculosis. Only 20.6% of the patients need to repeat BAE during 2 years of follow up.

https://www.tanaffosjournal.ir/article_248073_c94eb03710c9e0b615cd426de79962d6.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 20 2 2021 04 01 Practice of Surgical Treatment for Patients with Combined Echinococcosis of Chest and Abdominal Organs 140 149 248074 EN Bekdaulet Akimniyazova Kazakhstan’s School of Public Health, Public Health Department, Almaty, Republic of Kazakhstan Kazakh National Medical University named after S.D. Asfendiyarova, Pulmonology Department, Almaty, Republic of Kazakhstan Modern Medicine Center «MEDITERRA», Department of Thoracic Surgery and Pulmonology, Almaty, Republic of Kazakhstan Galina Kausova Kazakhstan’s School of Public Health, Public Health Department, Almaty, Republic of Kazakhstan Temur Yeshmuratov Kazakh National Medical University named after S.D. Asfendiyarova, Pulmonology Department, Almaty, Republic of Kazakhstan Modern Medicine Center «MEDITERRA», Department of Thoracic Surgery and Pulmonology, Almaty, Republic of Kazakhstan Kazakh-Russian Medical University, Department of Surgery, Almaty, Republic of Kazakhstan Daniyar Toksanbayev Kazakh National Medical University named after S.D. Asfendiyarova, Department of Surgical Diseases with a Course of Clinical Anatomy, Almaty, Republic of Kazakhstan Modern Medicine Center «MEDITERRA», Department of Hepatopancreatobiliary Surgery and Gastroenterology, Almaty, Republic of Kazakhstan Gulstan Esetova Kazakh National Medical University named after S.D. Asfendiyarova, Pulmonology Department, Almaty, Republic of Kazakhstan Journal Article 2021 12 16 Background: Epidemiological significance of echinococcosis is determined by the severe clinical progression leading to disability, incapacitation and death, a wide range of hosts, and formation of synanthropic and mixed lesions. The aim of the work was to analyze cases of combined echinococcosis of the chest and abdominal organs and the results of its surgical treatment in clinics of Almaty (Kazakhstan) from 1997 to 2019. Materials and Methods: In 413 patients, 534 lesions of echinococcosis were revealed: single and multiple cysts. Concurrent echinococcectomy of 2–3 organs was performed in 261 patients; meanwhile phased echinococcectomy was performed in several organs in 152 patients. Results: Performed surgical interventions in more than 70% of cases had a favorable outcome. Conclusion: The choice of rational surgical tactics for combined echinococcosis should be based on an individual approach, taking into account the general condition of the patient, risk analysis and the likelihood of complications.

https://www.tanaffosjournal.ir/article_248074_1f155858866b7f4a9f2e578c78990abd.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 20 2 2021 04 01 Determination of a Cut-off Point for Exhaled Nitric Oxide in the Diagnosis of Asthma in an Iranian Population 150 155 248075 EN Mohammad Borhani Fard Department of Occupational Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Mohammad Samet Shahid Sadoughi University of Medical Sciences, Yazd, Iran Mojahede Salmani Nodoushan Occupational Medicine Research Center, Iran University of Medical sciences, Tehran, Iran Department of Occupational Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Amir Houshang Mehrparvar Department of Occupational Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Amir Bahrami-Ahmadi Occupational Medicine Research Center, Iran University of Medical sciences, Tehran, Iran Journal Article 2021 12 16 Background: Asthma is a major source of global social and economic burden; thus, its early detection is important. Measurement of fractional exhaled nitric oxide (FENO) has been used recently considered a good indicator of asthma and also a sensitive and non-invasive method for monitoring airway inflammation. This study was conducted to determine the cut-off point of FENO for the diagnosis of asthma in the studied population. Materials and Methods: The subjects of this cross-sectional diagnostic study were assessed by the FENO test, spirometry, and methacholine challenge test. The best cut-off point of the FENO for the diagnosis of asthma was determined. The data were analyzed by SPSS 20 using student t-test, and Chi-square test and the ROC curves were also drawn. Results: The mean FENO in asthmatic and non-asthmatic subjects was 43.5±33.41 and 17.5±21.48 ppb, respectively (P <0.001). The best cut-off point of the FENO based on the overall sensitivity and specificity was 39.5 ppb. Conclusion: According to the results of this study, symptomatic patients with FENO higher than 39.5 ppb could be considered as asthmatic.

https://www.tanaffosjournal.ir/article_248075_d3393e63751c788821d00913315546ce.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 20 2 2021 04 01 Clinical and Epidemiological Characteristics of Coronavirus Disease 2019 in Iran: a Hospital-Based Observational Study 156 163 248076 EN Ilad Alavi Darazam Clinical Research Development Unit of Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Sajad Besharati Clinical Research Development Unit of Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Minoosh Shabani Clinical Research Development Unit of Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Shervin Shokouhi Clinical Research Development Unit of Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mohammad Fallahzadeh Clinical Research Development Unit of Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Hadiseh Shabanpour Dehbsneh Clinical Research Development Unit of Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Negar Khalili Clinical Research Development Unit of Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Azam Soleymaninia Clinical Research Development Unit of Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Akram Hoseyni Kusha Clinical Research Development Unit of Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Maryam Taleb Shoushtari Clinical Research Development Unit of Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mahdi Amirdosara Anesthesiology Research Center Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mohammadreza Hajiesmaeili Anesthesiology Research Center Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Omidvar Rezaei Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Ali Khoshkar General Surgeon, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Seyed Sina Naghibi Irvani Clinical Research Development Unit of Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mahnaz Kheyrian Clinical Research Development Unit of Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Fatemeh Goudarzi School of Management and Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran Journal Article 2021 12 16 Background: Coronavirus disease 2019 (COVID-19) has been pandemic and has caused a great burden on almost all countries across the world. Different perspectives of this novel disease are poorly understood. This study sought to investigate the clinical and epidemiological characteristics of COVID-19 to efficiently assist the health system of Iran to conquer the outbreak. Materials and Methods: This retrospective observational study was performed on 394 patients with a diagnosis of COVID-19. The patients should have a history of hospitalization at Loghman-Hakim hospital, Tehran, Iran, for 10 weeks, beginning from the first official report of the disease in Iran. In the subsequent step, the baseline demographic and clinical and paraclinical information of the patients was documented. Finally, the patients were assessed if they had exhibited any morbidity or mortality. Results: The epidemiological examination of the COVID-19 population suggested a bell diagram pattern for the hospitalization rate, in which the 4th week of the study was the peak. The highest rate of secondary adverse events due to the virus was observed at the 6th and 7th weeks of the study course. On another note, clinical evaluations resulted in identifying specific abnormalities, such as bilateral opacity in chest computed tomography scans or low oxygen saturation in laboratory data. Conclusion: This study provides evidence concerning the clinical and epidemiological characteristics of COVID-19 in the first phase of the virus outbreak in Iran. Further studies comparing the disease features in the subsequent phases with findings of this study can pave the way for additional information in this regard.

https://www.tanaffosjournal.ir/article_248076_9c8ed8c9ed8d221c830378dc5d4e8fdb.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 20 2 2021 04 01 Effects of Morphine and Fentanyl on Patients with COVID-19 164 171 248077 EN Ali Amirsavadkouhi Iranian Critical Care Society, Noor Afshar Hospital Research Center, Tehran, Iran Reza Shahrami Health and Family Research Center, National Iranian Oil Company (NIOC) Hospital, Tehran, Iran Nadia Mohammad Zadeh School of Medicine, Islamic Azad University Tehran Medical Branch, Tehran, Iran Saba Ilkhani Division of Vascular & Endovascular Surgery, Department of General & Vascular Surgery, Shohada-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Seyed Bashir Mirtajani Lung Transplant Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0003-4373-1383 Vahid Salimi Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Maziar Mahjoubifard Fellowship of Cardiac Anesthesia, Zahedan University of Medical Sciences, Zahedan, Iran Alireza Jahangiri Chronic Respiratory Disease Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0002-2705-4055 Journal Article 2021 12 16 Background: Sustained inflammation has been observed in the majority of severe COVID-19 cases. The impact of choice of opioid on perioperative inflammatory processes has not been assessed in the clinical setting. Materials and Methods: Patients with novel coronavirus (COVID-19) who referred to Masih Daneshvari and Noor-Afshar Hospitals in Tehran were included in the study after providing full explanations and obtaining written consent. Patients were then randomly divided into three groups: morphine, fentanyl and control. Patients in the morphine group received 3 mg of morphine intravenously every 6 hours for 5 days, whereas in the fentanyl group, 1.5 mcg / kg / h of fentanyl was infused for 2 hours on 5 consecutive days. The results were evaluated based on the design of the questionnaire and its completion using t-test and SPSS25 software. Results: A total of 127 participants responded to the survey between 20 April and 20 June 2020, of whom 90 (70.86%) with the average age 65.2 years, provided complete data on variables included in the present analyses. 53 (58.33%) of all individuals were men and 37 (41.12%) were women. Accordingly, 22 (24.4%) patients had a history of hypertension. However, diabetes with 16 (17.77%) cases and kidney diseases with 12 (13.33%), were the next most common underlying diseases. Evaluation of patients' clinical, laboratory and inflammatory conditions at different time intervals in both fentanyl and morphine groups did not show significant changes between these groups and the patients in the control one. Conclusion: The results of this study did not show any significant change in the use of fentanyl and morphine compared to patients with COVID 19. This may be due to the use of these drugs in the viral phase of the disease. The use of morphine and fentanyl in the viral phase of COVID 19 disease do not show significant benefits.

https://www.tanaffosjournal.ir/article_248077_4f3264603595651b5b3ea57a9aa80526.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 20 2 2021 04 01 COVID-19 Infection in Iranian Newborns and their Mothers: a Case Series 172 179 248078 EN Parisa Mohagheghi Department of Pediatrics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Javad Hakimelahi Department of Pediatrics, School of Medicine, Qom University of Medical Sciences, Qom, Iran Zohreh Khalajinia Department of Midwifery, School of Medicine, Qom University of Medical Sciences, Qom, Iran Parvaneh Sadeghi Moghadam Department of Pediatrics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Journal Article 2021 12 16 Background: The symptoms, severity, and prognosis of coronavirus disease 2019 (COVID-19) are surprisingly different in neonates versus adults or even children. Currently, there are few studies on neonatal and maternal COVID-19 with limited populations. Case Presentation: In this study, we present 13 Iranian symptomatic newborns with a positive nasopharyngeal COVID-19 test and their maternal data on COVID-19. All neonates were admitted to the hospital at the first day of life, mostly having symptoms at birth, except three cases that had symptoms at days 2, 11, and 22. Almost all cases had respiratory distress and were tachypneic, which needed respiratory support. Although most cases were discharged after recovery, two patients died at days 12 and 48. Conclusion: Neonatal COVID-19 cases mostly had respiratory symptoms and subsequent radiographic features of a viral pneumonia; thus, they had an effective response to oxygen therapy. The symptoms were by far less severe in newborns, although we lost two cases to this infection. This highlights the necessity for good COVID-19 prognosis in infants and neonates.

https://www.tanaffosjournal.ir/article_248078_ff8cf5f5fd61d7b80b88c062dbe61ef6.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 20 2 2021 04 01 A Severe Case of Bilateral COVID-19 Pneumonia with Concurrent Ischemic Stroke and Myocardial Infarction 180 183 248079 EN Neda Shafiezadeh Department of Internal Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Reza Ibrahimi Department of Internal Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Mahnaz Mozdourian Lung Diseases Research Center, Mashhad University of Medical Science, Mashhad, Iran 0000-0002-1692-4510 Journal Article 2021 12 16 Looking at the recent data provided in literature, we can see an association between cardiovascular and cerebrovascular accidents in COVID-19 thought to be related to severe inflammation and prothrombotic environment caused by the virus. This article reports a patient presenting with typical signs and symptoms of SARS-CoV-2 infection including flu like symptoms and respiratory distress. Initially a chest CT was performed that showed characteristic findings of atypical pneumonia caused by SARS-CoV-2 virus which was later confirmed with a nasopharyngeal PCR positive for COVID-19. During the course of admission patient developed unstable angina. Further testing confirmed an acute ST elevation myocardial infarction. While on anticoagulant treatment, patient showed signs of cerebrovascular accident. An emergency brain CT was ordered which did not yield any significant changes supporting our clinical diagnosis. Further diagnostic workup using magnetic resonance imaging disclosed evidence of cerebral ischemia in medial cerebral artery territory. Our study suggests that prophylactic anticoagulant regiment is not reassuring in COVID-19 patients and close observation and vigilance, can help clinicians to act timely and can improve patient survival.

https://www.tanaffosjournal.ir/article_248079_8183712791a0c9284ba3a3bfeb729995.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 20 2 2021 04 01 Pulmonary Thromboembolism Following Spine Surgery: Clinical Suspicion is the Key 184 187 248080 EN Kamran Mottaghi Department of Anesthesiology, Shahid Beheshti University of Medical Sciences, Loghman Hakim Hospital, Tehran, Iran. Farhad Safari Department of Anesthesiology, Shahid Beheshti University of Medical Sciences, Loghman Hakim Hospital, Tehran, Iran. Masoud Nashibi Department of Anesthesiology, Shahid Beheshti University of Medical Sciences, Loghman Hakim Hospital, Tehran, Iran. Parisa Sezari Department of Anesthesiology, Shahid Beheshti University of Medical Sciences, Loghman Hakim Hospital, Tehran, Iran. 0000-0003-3874-1050 Journal Article 2021 12 16 Pulmonary thromboembolism following spine surgery, although rare, could end into devastating outcome. Gold standard for it diagnosis is pulmonary CT angiography but in operating theatre, clinical suspicion is the key to diagnose. Here we report a case of pulmonary embolism with classic clinical findings which approved using pulmonary CT angiography and echocardiography.

https://www.tanaffosjournal.ir/article_248080_92bf4946c5ad9afb7a2b52980344959f.pdf